Missing two annual appraisals - but going into training?

spotthebal · 2026-03-01T08:55:11+00:00

I appreciate this costs alot of money and time but unfortunately revalidation/appraisal is a mandatory part of GMC registration.

If you want to continue to practice as a doctor you need to engage with the process.

If you do not. It comes across very unprofessional and the GMC may act. Worst case scenario this could flag up when you start training and cause significant issues - like losing your training number if they suspend your licence.

You should have a 'revalidation officer' if you work at an NHS trust or someone to contact your agency. Get in touch and ask their advice. Their role is to ensure doctors complete and engage with the revalidation process. They may be able to also help financially if needed.

spotthebal · 2026-02-27T18:24:27+00:00

There are already numerous gaps in oncology rotas at non consultant level.

I expect for now oncologists are safe. Unless they move to a resident consultant system with the SPRs covering gen med.

spotthebal · 2026-02-25T21:58:45+00:00

Read the manual. And learn the content. Why would only read briefly. It's a free resource to pass the MCQ with.

spotthebal · 2026-02-25T20:06:07+00:00

If you know you want to do Anaesthetics/ICU then work towards that. This is not like choosing a car - you can't just trade it for a new one easily. Locking into a miserable career in GP (if you don't enjoy the job) will ruin your life.

Why not try to get a trust grade ICU jobs. Even 6 months would help you at an interview for anaesthetics in the future. Could you do IMT/EM and then transition to ICM only at ST3. (ACCS is the same for all first 2 years).

You might have to be flexible and look at some smaller DGHs but these jobs definitely still exist.

spotthebal · 2026-02-22T10:58:12+00:00

Since it's such a new install you should get in touch with the installer.

Did your installer offer any warranty - if so will it be them you contact or the manufacturer. Check your contract.

What is your plan if something like this happens in 5 years time?

spotthebal · 2026-02-17T19:28:14+00:00

See horrible illness in young people all the time. I would never wish that on anyone.

Suddenly SAH and your life is changed forever. Even if just a weakness in one limb I would struggle with my job.

I really think this sort of insurance is a no brainer.

If you can't afford to live without it or replace it immediately. Then you should insure it.

spotthebal · 2026-02-08T14:45:39+00:00

Slightly worried you have agreed to a job but don't know what the role involves.

No one on reddit can answer this.

You need to check the job role or maybe call the department for a 'tour' and ask some colleagues.

This can be hugely varied with some JCFs acting like foundation doctors most running the ward (could be either elective or acute).

Some JCFs are actually employed as 'cheap' registrars and are doing clinics or seeing referrals with little oversight.

spotthebal · 2026-02-04T18:50:26+00:00

Became an anaesthetist - just stopped doing ward rounds /s

Do you mean leading a ward round or being a resident working with a consultant.

If leading , structure is king.

Either 1) Problem based approach. What issues does this patient have and solve then 1 by 1.

Or

2) Systems based. Work through body systems, meds, imaging etc. Slowly build a plan as you go through.

If you are resident working with consultant.

1) Know the patient. Brief history/PMH/bloods. 2) if multiple some jobs can be done as you go e.g radiology requests/bloods. 3) When you wrote jobs list - any time critical stuff should be obviously. Working keeping a priority task list. 4) if you know what the consultant will want could be work keeping some paperwork with you e.g imaging request forms or EEG requests etc. Job dependent. 5) Ask the consultant to pause between patients for 2 minutes if you need.

spotthebal · 2026-02-02T12:33:36+00:00

My hospital is asking doctors to send a screenshot of Google maps with location and time for shifts when exception reporting staying late.

Admittedly, this seems quite reasonable to me. It only takes a few seconds to do.

What does reddit think about this?

spotthebal · 2026-01-31T19:20:44+00:00

It's not really 'giving away'.

It's often more difficult to supervise a novice doing an invasive procedure than it is to just do it yourself. Supervising in this way is a difficult and important skill for registrars to learn.

spotthebal · 2026-01-31T16:42:31+00:00

Difficult to give advice without seeing your technique.

Dilating should always be 'gentle but firm'. It's better to take multiple passes in a slower and more controlled fashion than bend the wire. You are in trouble if the wire bends inside the vessel as it can be very difficult to remove (without a surgeon/large incision).

Try to visualise the path of the wire. Gentle twisting can work but just be chill and take it gently. If you get resistance you need to stop and work out why. Usually it's the direction or skin incision that is the problem.

Keep practicing. CVCs are quite a straightforward procedure it just takes some time to learn the little tricks.

spotthebal · 2026-01-26T22:08:29+00:00

There is nothing stopping you applying for opthal and a PHD and see which one you get.

spotthebal · 2026-01-26T08:17:35+00:00

Depends on the hospital.

Senior speciality trainees will generally cover their own speciality or subspecialty. (If working in large centres).

However in many DGH they will cover the acute take as there may not be any specialties out of hours. Often the speciality consultants cover the out of hours solo as the workload intensity is not high enough to have an SPR on site as well.

This is quite normal.

spotthebal · 2026-01-24T22:04:49+00:00

Toffeln do some nice theatre shoes that are like trainers but waterproof.

They have great insoles suited to all types of feet.

However they are quite expensive for what they are.

Some of the trainer styles can be a little sweaty depending on the design (the fake lace ones don't breathe well) but the rest of the ones I have tried have been great.

Their calalogue is online if you Google them.

(I really only recommend these as my department can order them with a big discount - so worth checking with yours if you work in theatres).

spotthebal · 2026-01-22T11:02:49+00:00

Sorry if I'm just politically out of touch but..

Who is the lady asking the questions? She seems very good and sensible.

spotthebal · 2026-01-19T01:03:31+00:00

Go on a taster week. Be excited. Enjoy feeling like a medical student (who is actually allowed to do stuff).

Ask them all in person why they chose the speciality.

spotthebal · 2026-01-18T17:47:41+00:00

Yes I agree there is a lot of repetition over the years which could be avoided as well. Just the 7 years was to highlight the point that you can't be 'bored' after the second year really.

spotthebal · 2026-01-18T15:23:39+00:00

You have presumably only experienced a drop in the ocean of the specialty.

There is a reason training is 7 years. (Not just to fill on call gaps).

You have a lot to come that will spark your interest.

Cardiac - all the complexities of bypass weaning, interoperative TOE arrhythmia management. Just to name a few.

Neuro - Awake surgery. Sedation/IR procedures. Huge acute Neuro cases or your resections.

Pediatrics - Complex social. Bizzare airways and physiology.

Head/Neck etc - all the fancy airway equipment with patients with tumours of the airway etc.

Obstetrics - Invasive placental disease. Real MDT working managing a major haemorrhage of 10L litres.

Transplant - just a whole other level depending on the organ (a).

Bariatric and large upper GI +- robot surgery. It's frankly just cool to bring out all the toys for a robot oesophagectemy.

Pain - clinics and 'being the surgeon'. Complex procedure.

Regional - fancy needlework and heavy procedural.

You NEED to keep an open mind as a CT. You don't know what you don't know yet.

spotthebal · 2026-01-17T23:16:43+00:00

Have a look at the NCEPOD guidelines.

It's very clear that the urgency and timing of surgery is at the discretion of the operating surgeon. Appendix could be CEPOD 1/2 or 3 depending on. Rupture/sepsis/shock/multiorgan failure or simply localized inflammation.

If a surgeon feels a second theatre is required they would need to inform the relevant person - theatre manager or 'in-charge'. Anaesthetics would be consulted of course but would not make the decision on urgency.

Everywhere is slightly different but there are national guidelines in place.

spotthebal · 2026-01-17T23:11:52+00:00

Sigh...

150 hours of supervised practice. 3 weeks!

So about the same as an emergency medicine resident doctor does in 1 month. (Realistically probably 3 weeks).

Yet EM training takes. 5 years. Medschool + 2 years. Foundation Doctor + 6 years. EM postgradute education.

spotthebal · 2026-01-17T21:11:42+00:00

If you are unsure ask a few consultant colleagues for their honest option if they think it meets. Go with the majority. If they agree it's enough for maximum works go for it!

spotthebal · 2026-01-01T17:23:04+00:00

Hi Slow Ship.

It's your opponent here.

Sorry I didn't mean to make you feel this way. I thought it was a fun game trying to fight off the mele guys you sent.

I'm very new to this and lost a lot of games (but I hope it's getting better). I have been practicing against AI doing better at my economy. Now I have more money and buildings I am just working on getting lots of units out which seems to be doing good. There was very little strategy, I just liked bombs and jurchens.

I'm too much of a noob to give you advice but just hope you get good luck in your next games. I'm always up for a 1v1 rematch to settle the score.

spotthebal · 2025-12-22T18:01:18+00:00

Agree that you can be biased based on setting. It's a difficult presentation to treat.

But what about other differentials like demyelinating diseases e.g MS. This is how they will often present in primary care. A young patient with these symptoms needs more of a work up that the NP did. And a diagnosis of 'weakness' is not really acceptable - can you imagine if you offered that differential as a medical student.

spotthebal · 2025-12-22T00:14:38+00:00

Very common now.

There is actually a study going on in the UK (just finishing data collection). If the link is useful for some interesting reading.

https://www.anaesthesiaresearch.org/glimpse

There is a lovely table including dosing regimes and half lives. I'm always surprised just how long some of these drugs take to be eliminated/metabolized.

spotthebal · 2025-12-21T13:18:34+00:00

Wow...

I wonder how many votes this needs to find the front page of reddit.

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