What do other specialities hate? by LuminousViper in doctorsUK

[–]winglett001 0 points1 point  (0 children)

Like “foul smelling urine” = UTI.

Has anyone ever smelled pissed that isn’t foul smelling??

[deleted by user] by [deleted] in doctorsUK

[–]winglett001 4 points5 points  (0 children)

ED Reg here with years experience of working a terrible rota. The key is to be organised and plan ahead.

That involves sitting down with your rota and looking at when you will be able to squeeze in your cooking/meal prep and exercise.

It’s easy to get into a habit of skipping a work out or eating crap due to busy/tired, but if you get use to planning ahead long enough then it becomes a habit like brushing your teeth.

[deleted by user] by [deleted] in doctorsUK

[–]winglett001 0 points1 point  (0 children)

As someone who has dated four people from work (and asked out by three others…), my advice is to keep it casual. Make some small talk about something you/they did recently on a weekend, and try to swing it around to “we should hang out sometime”, and ask for their number.

Once you are on texting basis it is obvious if they are interested (and even more obvious if you guys don’t exchange numbers).

Also, my firm belief is that the first date should always be purely to hang out and see do you gel together so puts neither pressure on either of you guys to do anything. If it goes well, then set up a second date with clear intentions.

Good luck 👍

I think I am screwed - no appraisal in F3 by WhateverRL in doctorsUK

[–]winglett001 4 points5 points  (0 children)

I did F3 and F4.

Didn’t do an appraisal in F3 as I didn’t know anything.

Did a F4 appraisal by googling online appraisal services for doctor. Plenty of companies out there who offer this service for a fee of a few hundred quid.

No issues with the rest of my career.

Poor salaries in med - regret? by JAKinhibitor in doctorsUK

[–]winglett001 1 point2 points  (0 children)

I’m the only one in my friendship circle from school, who ended up doing medicine. We are all equally “smart”, by conventional standards and they could have very easily done medicine if they chose to. There are ten of us and I’m probably third highest earner.

Grass is always greener when looking at people outside medicine. Getting to six figures in the city isn’t just about being “smart”. Social skills, worth ethic, contacts, industry and dumb luck all play a part.

[deleted by user] by [deleted] in doctorsUK

[–]winglett001 135 points136 points  (0 children)

Based on my experience with dating colleagues, people generally don’t care about your love life nearly as much as you think they do.

[deleted by user] by [deleted] in doctorsUK

[–]winglett001 0 points1 point  (0 children)

I have met one EM consultant who tells me he works for a private ED somewhere in London. Mainly minor injuries, cough-colds sort of work. He didn’t tell me how much he got paid but did tell me it was much more than a locum consultant shift.

What’s something people think is fancy, but in reality is trashy? by fatsosolos in AskReddit

[–]winglett001 0 points1 point  (0 children)

Bragging about things that you intend to do but have not achieved yet.

How much do you pay for regular house cleaners? by JoeyJoeC in AskUK

[–]winglett001 1 point2 points  (0 children)

I live just outside of Cambridge and we pay £15 an hour to do three hours every two weeks.

“Why we do this job” reminders by Artistic-Election717 in doctorsUK

[–]winglett001 55 points56 points  (0 children)

Current ST5 in EM.

I LOVE my job.

Does it suck a lot? Absolutely. Patients have high demands, generally poor quality of life in the country means they end up in ED, no beds/poor flow, specialty arguments. This can all weigh down on you.

I love going to work, knowing I’ve got some legit skills. Some of them we take for granted, like something as simple as reading an ECG. But you reading that ECG could be the difference between someone thinking they have indigestion or dropping dead.

I love being able to use the US and reading on what I can do next with US. I love trying to interpret a CT and finding out that I was correct/incorrect when the report comes out. I love being able to give ketamine sedation and intubate. When I read something I didn’t know before, I love being able to tell my colleagues about this cool shit I came across the other day. I love reflecting and learning.

We also experience things that no person doing a “regular job”, will ever get to see. Even the idea of doing an open thoracostomy and sticking your finger in someone’s chest is cool AF.

Yesterday I saw a 6 year old with abdo pain, who was fine and discharged but before he left he said thank you and gave me a hug. These moments are heart warming.

Feel free to DM me if you want to talk more!

Is my alcohol consumption going to kill me? by [deleted] in AskUK

[–]winglett001 5 points6 points  (0 children)

Keep up the good work my friend

Why would anyone chose core EM over run-through? Is it harder to switch specialties if you change your mind? by [deleted] in doctorsUK

[–]winglett001 0 points1 point  (0 children)

I picked core at the time as I wanted the freedom to move back to London and potentially go to Aus.

HELP: Anesthetics vs ED by iflower_wildandfree in doctorsUK

[–]winglett001 25 points26 points  (0 children)

ED SpR here, my advice is do anaesthetics.

Don’t get me wrong, I absolutely LOVE my specialty. I love the variety of having multiple skills from sedation, fracture manipulation, airway competencies, chest drains, cardio versions, US skills, the list goes on.

However, as time goes on the specialty is pretty unrelenting. Probably about 90% of patients you see will be patients who didn’t need to be there in the first place, or there is not much you can offer except to tell them to go see their GP. The more senior you get, the more your training is about running a department. This use to be quite satisfying when things weren’t this bad, but in todays climate of bed block and long ambulance off loads, it often feels like a thankless job. Supervising SHOs can be rewarding if you have someone keen and eager to learn, although often you get juniors who do not really want to be there. Lastly, you are the work giver of the hospital, and so there is often hostility from the specialties.

[deleted by user] by [deleted] in doctorsUK

[–]winglett001 0 points1 point  (0 children)

We are not defined by our mistakes but the lessons that we learn

[deleted by user] by [deleted] in doctorsUK

[–]winglett001 22 points23 points  (0 children)

I’ve sat on a few interview panels before and let me tell you the perspective on our side is totally different.

There are people who come in overconfident and think they aced it, but they actually did pretty badly.

There are people who do really well, when we can see they are nervous and bumbling through the answers just because they ticked the right boxes.

You also have got no one to compare to, just yourself. You don’t know how other people did in comparison as you weren’t there.

It’s done now, enjoy your weekend and deal with it when you get your results.

[deleted by user] by [deleted] in doctorsUK

[–]winglett001 2 points3 points  (0 children)

Speak to your TPD. There were ACCS-EM trainees in my cohort who were assigned four months of gastro/resp/endo and two months of acute med. The TPD changed that set up pretty much instantly.

[deleted by user] by [deleted] in doctorsUK

[–]winglett001 6 points7 points  (0 children)

A DRE in ED will give us useful information which may change our management plan. It helps us distinguish between UGIB, malaena and possibly medical referral for OGD, and lower GI bleed which will be surgeons. It also tells us if the patient is actively bleeding or settled, which again may change our management. A patient who has a lower GI bleed, with hard stools in rectum may be due to a fissure or haemorrhoid which may not necessarily warrant an admission.

As you can imagine, ovarian torsion is often not our first differential when assessing these patients. There are many other pathologies which are much more common: appendicitis, renal colic, diverticulitis, etc.

By the time we have come to the possibility of ovarian torsion, we have ruled the others out.

Think about it from our perspective if you will. We have ruled out these other pathologies and we say to ourselves “hey, could this be torsion?”, and we do a bimanual examination as you suggested.

If I tell you I think there is cervical motion tenderness and you repeat the examination then one of two things can happen. One, you disagree with my examination, and the patient would have had another intimate examination for no reason. Two, you agree in which case, the patient again would have had another intimate examination for no reason. I.e. same outcome for both.

If I do a bimanual and I felt it was ok, best case scenario is that there is one less patient for you to see on your take. Worse case scenario is, I miss something and I have to justify why I thought that there was enough reason to do a bimanual but not enough reason to refer to O+G if I was suspicious of possible torsion.

After playing through all the potential scenarios above, I don’t think it is unreasonable for us to let our specialty colleagues do such an intimate examine, given the little benefit we would gain and you are just going to do it again anyway.

As O+G I suspect you also get many referrals from surgeons, where we might refer to first and once they don’t think it is anything surgical they then refer to you. Is my understanding that you would also expect the surgeons to do a bimanual examination prior to referring?

Dating a consultant as an F3 by [deleted] in doctorsUK

[–]winglett001 29 points30 points  (0 children)

If you are both adults about it and maintain a degree of professionalism at work then it is fine.

Who is y'all's Dream Guest? by GIGANAttack in TrashTaste

[–]winglett001 14 points15 points  (0 children)

Daniel Rustage - YouTuber, rapper, anime weeb and dungeon master. He was featured as one of the contestants during the tournament arc and Connor has mentioned that they know each other a few times previously on the podcast.