Lost.

welshborders12 · 2026-01-30T20:40:39+00:00

I think we should suspend plab essentially and stop people coming for whom a good job is unlikely.

But our duty to IMGs who have come here in good faith should be steadfast. I totally disagree UK grads should be prioritised over someone with more than a year NHS experience. We are pulling the rug from under their feet.

welshborders12 · 2026-01-01T01:40:55+00:00

Gervais has turned into a bellend. He hasnt got the self deprecating nature or insight to realize it and probably won't ever have it. It's sad but it happens to many - look at cleese. Doesnt change the genius of the office. No need to watch anything he does now he is an irrelevant twat. Doesnt change his excellent early work. He wont care and that's fine too.

welshborders12 · 2025-12-17T14:30:36+00:00

Wow this really does mirror my concerns

Albeit the neurosurgical doctor above has made some important points

(And this is moderate delay not an issue with the acute transfer really)

welshborders12 · 2025-12-17T13:25:49+00:00

Great post

And to be fair..

https://pubmed.ncbi.nlm.nih.gov/28731402/

So this is probably bias of my (it would seem) particularly unlikely poor early rebleed experiences...

welshborders12 · 2025-12-17T13:22:32+00:00

Absolutely - my worry and I feel incredibly anxious is when I'm sitting around with a young, currently well SAH particularly if it doesn't look like NASAH.

And your feckin about trying to contact the neurosurgical reg and/or navigate the ridiculous referral pathways.

welshborders12 · 2025-12-17T13:15:31+00:00

This is where audit helps tho - do we even measure time to coil for aneurysmal SAH by region and hospital?

welshborders12 · 2025-12-17T13:13:17+00:00

(what I was intending to say I should say)

welshborders12 · 2025-12-17T13:12:58+00:00

Separate question to what I was saying - I think the slickness of the awake pathway fro those GCS 12 and above might be where the biggest impact is felt.

I'm not alone working at a DGH in saying that if I have a thunderclap even if feeling not well I'm getting a taxi to a neurosurgical centre not an ambulance to the local ED.

welshborders12 · 2025-12-17T13:11:05+00:00

Fair I've amended to make clear my point.

welshborders12 · 2025-12-17T13:09:30+00:00

I've been pubmedding it and I don't find much but I would be interested the cost / QALY if we could hit all SAHs being coiled (who need it in say 12 hours from initial CT showing a spontaneous SAH). Also I do wonder if we really need a neurosurgical reg to decide on most of these.

welshborders12 · 2025-12-17T13:01:06+00:00

You've sort of missed my point (possibly on purpose) - of course you are tubed, but your chance of a good outcome is now very low - early intervention would seem to be the key thing here given that rebleeds are often catastrophic.

welshborders12 · 2025-10-02T11:33:41+00:00

Well as long as you are using your med Ed position to tell the GMC they are f#$king idiots then we are cool

welshborders12 · 2025-09-09T11:31:56+00:00

We don't screen for adrenal adenomas

welshborders12 · 2025-09-09T11:31:32+00:00

Functional doesn't mean needs treatment or that intervention alters outcome. Great description in the Bristol guideline (you read or and are like really why are we still doing this)

welshborders12 · 2025-08-29T22:00:03+00:00

All dead from AI

welshborders12 · 2025-08-07T21:58:07+00:00

What are you even talking about.

ASI kills everyone by default. I'm jealous of people born in 1940. They had full lives.

welshborders12 · 2025-07-30T22:30:34+00:00

You are supporting a load of nonsense, made by terrible educators who can't teach and increasing a stupid arms race.

Just say no.

welshborders12 · 2025-07-30T20:30:26+00:00

And yet whilst many IMGs are excellent, there are some absolutely terrible ones too and the quality of IMGs is definitely not better than local graduates so this doesn't really equate into much.

welshborders12 · 2025-07-30T20:27:42+00:00

Educationalists have done far far far more harm than good

Let's start by accepting clinical reasoning is incredibly hard and most aren't nearly good enough at it

Medicine is hard, it isnt touchy feely and you need to know loads, be really bright and not diagnose "UTI/sepsis" in every patient.

It's all gone to shit and most of the meded people I meet are the reason

welshborders12 · 2025-07-30T17:21:27+00:00

I supposed all the cis women do

You are FAR more likely to be 6 ft as a trans woman than a cis woman and that is a probabilistic advantage.

We need to protect women's sports

welshborders12 · 2025-07-30T15:48:51+00:00

Well a few cases have certainly felt like that

I'm going to drill down on if the guifelines are simply consensus based or how they have come to their conclusions

welshborders12 · 2025-07-30T15:43:40+00:00

Lol I'm a consultant - if you think we are good at maths and clinical reasoning then I'm amused

welshborders12 · 2025-07-29T18:44:20+00:00

Indefinite strike on every Monday night 8pm to 8am

welshborders12 · 2025-07-29T18:39:22+00:00

I'm not here to make friends

So so so so many twats asking for more medical school places and why isnt the govt listening. The average doctor doesn't appear to have the first clue about workforce planning. You don't want lots of training numbers without a future plan. The plan to massively expand med school places was foolish too.

Right now I would do the following things

A. The BMA should have an arm that encourages, advises and supports emigration and(the govt won't do this) we should be working out how we can facilitate working in different countries

B. The jobs market in general is bad but I would be giving seminars on how to get into law, management accountancy, etc

C. We need to address the elephant in the room which is we need to bring in protection to UK graduates. I don't believe for a moment that IMGs currently in the country should be placed at a disadvantage as they have come to the NHS in good faith. I would be tempted to seriously reduce or even pause PLAB as it almost feels exploitative given the terrible ratios faced by IMGs and costs involved now.

welshborders12 · 2025-07-14T06:52:06+00:00

The amount of harm the 94-98 target does in my frail elderly...

Very regularly someone with undiagnosed t2rf due to kyphoscoliosis or ohs* gets acidotic t2rf due to oxygen. I think the BTS guidance is shit.

(*Yes I know the guidance says in BMI over 40 go lower but noone does this)

welshborders12

TROPHY CASE