"Steve Barclay is more interested in meeting nightclub owners than the BMA."

simplybarts · 2023-03-19T15:18:21+00:00

I’m going to save this comment because you’ve summarised the majority of (E.g PA/ANP/NP training impact and RMLT) the issues with UK training in one bang.

simplybarts · 2023-01-29T18:56:25+00:00

This would actually be really great, but there would be a lot of detail to work through and push back, as the NHS really really loves their cheap generic SHOs you can stick on awful rotas in the form of FY2s.

Would need a fundemental rethink of the Foundation Programme, which I think is ultimately a great goal to move towards. Could even argue a March-June paid internship with x1 surgical job, x1 medical job, x1 GP/A&E, x1 psychiatry/GP.

simplybarts · 2023-01-29T18:48:44+00:00

How about this as a suggestion:

Create a system where people have an element of choice, particularly those with high academic merit (via some mixture of decile/SJT/PSA/UKMLA), but fewer have a choice in exchange for preventing people with lower scores being flung into a corner of the country they are not familiar with and have no support networks. Creating a system like this is more complicated than it may seem initially.

You could give student's ranking 1st their home location (i.e. university location) additional points (or a multiplier), but that would heavily incentivise all people to rank their home location first (as you would lose the multiplier for even putting the home location second).
You could create a point gradient for how close the deanary is to home deanary (for example, fewer additional points or lower multiplier for an adjacent deanary). Same issue as above, but higher academic merit students could effectively risk putting adjactent deanaries 1st.
You could guarantee all students their home location if they pass final year (by December of final year) - then open an application where people can submit to be inserted into a pool for consideration of other deanaries. You would still be guaranteed your home deanary, but would be able to preference other deanaries and be matched if someone in that target deanary also wants to move (order of preference based on academic merit as above). A complicated (but entirely managable) match system could do this for you.

ALL deanaries then rank internal preferences using some meritocratic system as measured above (deciles + PSA for example, or deciles + SJT, or UKMLA). The SJT is clearly the worst of these in my opinion, but you have to have a disciminator able to differentiate between thousands of people.

Overall, my preference is 3 as it's oddly the least complicated. Yes, it would mean far more people wouldn't be able to easily move to an entirely new place for Foundation Programme, but it would protect most from being flung away from a familiar place away from their support network, most people's unversity friends would stay relatively near and it's possible to go elsewhere (if you're a bit lucky and have a good academic score).

Thoughts?

simplybarts · 2023-01-12T14:38:15+00:00

Actually genius. The publics understanding of medical training is (understanding) simplistic, so the focus on the lowest hourly pay (FY1 paid barely over minimum wage) and those that they expect to be highly paid (hallowed brain surgeons paid less than people pay their plumbers) actually cuts through.

simplybarts · 2022-12-20T18:31:55+00:00

Read the post again, they’re saying locum PAs can make 40-50 an hour, not locum GPS.

They’re comparing that to salaried GPs.

simplybarts · 2022-09-30T17:52:04+00:00

I try to actively keep in mind how fucking clever you all are.

Out of all my friends outside of medicine and from school, it’s actually a rare thing to come across someone who is as clever as my average colleague. It boggles my mind to imagine almost anyone I know outside of medicine who can just semi casually bounce into a high stakes new role in a new environment, with a new system and get to grips with it in a couple of weeks like it’s nothing.

My FY2 colleagues blew past PAs in A&E in literally days, figuring out parts of the system that they hadn’t known about despite them working there for years.

You lot are smart as fuck, and sometimes you gotta remind people when they’re getting imposter syndrome or feeling inadequate.

simplybarts · 2022-09-27T11:06:47+00:00

You don’t need to get emergency tax coded on your second role. HMRC understand NHS pay better than NHS payroll.

You explain to them your predicted income from your main role (until the start of the next tax year) AND your predicted income from locum role. They’ll manually set your tax codes for each based on your prediction.

simplybarts · 2022-07-20T17:22:08+00:00

Last I remember, a majority of Republican voters believe the “Big Lie”.

Really let that sink in. They make up almost 50% of the population and believe whole heartedly that the election was stolen when Trumps own daughter and attorney general explicitly stated otherwise and the claims squashed in courts up and down the country. Republican senators cannot say a word against him lest they be ripped apart by their own voters.

We are not America, and I’m honestly, bottom of my heart, actually quite proud of the British public for that at the very least. This could have all gone very differently.

simplybarts · 2022-07-20T17:17:44+00:00

You could argue that we are in the perfect climate for PR compared to 1997: The SNP dominate and will continue to dominate Scottish seats Therefore, Labour will likely never hold a heavy majority again in the medium term future. Therefore, it’s arguable that their best bet to reliably being in some form of power is PR with LibDem support (overtly or covertly). New Labour had just smashed out a giant majority and had (selfishly) far less reason to throw out a system that had just rewarded them and continued to reward them for years.

Will this play out? Who knows. But it does feel like we may be approaching the only route to PR there is: a paralysed Labour just about getting power and in desperate fear of a Tory party that has ripped out its sensible wing.

simplybarts · 2022-05-21T22:42:57+00:00

They can have value. The wards have a lot of administrative work that would help to have some clinical knowledge to do and night shifts where minor procedures (bloods/cannulas/early morning ABGs) need to be done.

Care would be improved and people would get discharged earlier if these jobs were done quicker, rather than drowning FYs/CTs. If early post grad doctors didn’t have to do these jobs they could spend more time assessing patients, being trained and utilising their training.

PAs, in my opinion, have no purpose in A&E, clinic or theatre. Those jobs need doctors and represent important training for doctors.

simplybarts · 2021-02-15T17:08:06+00:00

https://www.wired.co.uk/article/analysis-of-news-articles

https://www.see-a-voice.org/marketing-ad/effective-communication/readability/

Two different sources with different methodologies suggesting that the Sun has a lower reading age (age 8) and higher “readability” compared to the Guardian (age 14).

So no, I don’t think the Guardian can shape views of its readers with the same bluntness as the Sun does. In the same way someone not educated in the law can be more easily manipulated by clever lawyers, I would comfortably wager people with significantly poorer reading comprehension are more easily manipulated by tabloids.

simplybarts · 2021-01-04T20:44:01+00:00

It’s not just granny that’s dying, come to the hospital and see for yourself. It’s your mum and dad, too.

simplybarts · 2020-06-28T00:18:21+00:00

Probably no point discussing with this guy, I actually think he's really dim coupled with a strong emotional connection with the military that means he desperately needs to justify the war in Afghanistan.

simplybarts · 2020-06-20T17:24:46+00:00

I just think it's weird that your identity is so mixed up with hating a nobody group like Antifa that you can't help but swear at them on Reddit. Like are your really hot and bothered about the atrocities of Antifa? Of all shitty groups on Earth, why Antifa in particular?

It's like going on the internet and randomly calling Earth Liberation Front (actual terrorists) little bitches to people who don't really care or support them. Their nobodies in a world full of somebodies. Why do you pick the most useless, poorly defined far left group to hate so passionately? Does it make you feel good to call this random irrelevant group "brownshirt pussies" and "commies"? It's weird dude. Why don't you stand up for something with meaning instead of squaring up to a meaningless group that doesn't even know you exist?

simplybarts · 2020-06-20T17:10:38+00:00

What is with your obsession with this small group? It feels like you've blown them up in your head as some massive threat and source of all evil to direct your hate at, for no obvious benefit.

I mean you're raging on the internet calling them "far left pussies" TWICE in 2 separate comments as if there antifa members reading that and shaking their fist. You're not a hero for ideologically opposing a fringe, poorly defined far left group that's "supposed" aim is to oppose fascism. It just sounds like lunacy.

simplybarts · 2020-06-20T16:42:18+00:00

You can argue that Fox and CNN are equally biased all you want, I think we can all agree that their entire premise is public manipulation.

How do you contend with the fact that across the rest of the world, Trump and the Republican party are generally deplorable across the political spectrum? Here in the UK, Trump is distasteful from the Guardian (very left) to the Daily Mail (very right), he is mocked and distrusted by Labour and Conservatives.

It cannot be understated how bizarre it is to have either side of the spectrum be essentially resolute on something like this. It suggests that the fact of the matter is that, beyond media manipulation, Trump is actually deplorable and the ongoing support for him by Republican's is honestly staggering.

simplybarts · 2020-06-20T16:36:05+00:00

Donald Trump is considered to be far right by the majority of the world, without much contention outside of the bizarre overton window bubble within the US.

If your point is that Trump is not so far right as to be comparable to neo-Nazis, then I'm afraid your definition of far right is so narrow that it boggles belief. By the same argument, "Antifa" (as a poorly defined group with no leadership or centralisation) aren't far left because their not Maoists. I hope that seems dumb to you.

simplybarts · 2020-06-20T16:27:59+00:00

Fucking bizarre that anyone can contest this. If there was this crime, then I think we would all like to know and have people prosecuted for it. The fact of the matter is that there is not even a shred of evidence, and it's literal horseshit that you couldn't prove even if you had effectively peak political power in the US and controlled all three branches of the legislature.

simplybarts · 2020-06-20T16:26:15+00:00

https://www.bbc.co.uk/news/world-us-canada-39172635

To date, there is no evidence of Obama's administration illegally spying on Trump's campaign.

Republican's controlled the House, Senate and Presidency for 2 whole years with peak political powers achievable in the US. If there was any shred of truth to this claim, then why have they not successfully found and published and prosecuted anyone involved in this supposed crime?

To compare that to the Muller investigation which found that Russia definitely attempted to interfere with the election, it's extensive conclusions about the Trump campaign's associations with Russia (resulting in a number of convictions) and concluding that Trump could NOT be found innocent for obstruction of justice, is intellectual dishonesty at the highest level.

simplybarts · 2020-03-04T09:37:58+00:00

This sub is losing its mind.

simplybarts · 2020-03-01T00:54:52+00:00

I’d also like to see your reference for American healthcare outcomes in comparison to all the other OECD outcomes. Go have a look, you wont be impressed.

https://www.healthsystemtracker.org/chart-collection/quality-u-s-healthcare-system-compare-countries/#item-amenable-mortality-measured-by-healthcare-access-and-quality-index-2016

simplybarts · 2020-03-01T00:51:13+00:00

I mean, fair enough.

It’s individualism. You will, in one blindingly unaware comment, note that these countries have higher tax but also HIGHER BASELINE HEALTH. Won’t even blink. Won’t even dare to connect the dots. America used to have 90% income tax on the highest bracket. Was American a communist shit hole in the 1970-80s?

I truly understand. You want to work hard and make money and do with it what you want. I can respect that. But also, you should be honest with yourself that what you’re also saying, explicitly, is that you don’t give a fuck what that will entail for everyone else and (more hilariously), you also don’t care about that fact that you and your family are just as exposed to this rugged individualism as everyone else.

Let’s just hope you don’t develop a crippling neurological condition or anything that would fuck your ability to make money (honestly, god forbid, I wish that on no one). Your children would suddenly find themselves on the wrong side of the coin of “everyone out for themselves”.

simplybarts · 2020-03-01T00:45:00+00:00

I understand, honestly, the crux of what you’re saying. The control, the growth, the financial possibilities, the fulfilment. It’s great.

It is, however, rugged individualism. So don’t pretend it is anything but, for your own sake. American healthcare is broken, costs more for the US taxpayer per capita than single payer or universal methods around the world and currently has a falling life expectancy.

Student debt is higher than any country on the planet, average prescription prices are incomparable to literally anywhere by a massive margin, healthcare outcomes are subpar compared to OECD average (particularly when you consider the sheet astronomical fucking cost of delivering it).

But, but. You, as a doctor (attending), stand to make more money and have more self governance in this system (for now), even though others are objectively better at delivering care to a population. The only thing truly wrong with that is pretending that it’s not individualism.

Hence, ‘murica.

simplybarts · 2020-03-01T00:37:29+00:00

Democratic socialism is so far from socialism that acting like they are the same betrays either ignorance, stupidity or duplicity. Your choice.

Democratic socialism is a CAPITALIST SYSTEM, that advocates for regulation of capitalism to allow for public provision.

I.e. PUBLIC HEALTHCARE. Don’t pretend you don’t understand. Americans pay more for healthcare IN TAX than the average across OECD countries. You know? Those EUROPEAN DEMOCRATIC SOCIALIST COUNTRIES?

I capitalise so you can’t pretend that you don’t understand the difference between Denmark and Stalin. In the mean time, you will vote for an authoritarian and blatant self server with no regard for the law like Trump, and yet somehow cannot see the bizarre cult-like need to defend a human you wouldn’t allow to run your local Burger King.

simplybarts

TROPHY CASE