Robert Golding
@DrRgoldi
Followers
442
Following
304
Media
137
Statuses
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Anaesthetics/ICM, former amateur racing driver and intermittent lycra loony. Opinions own. #DocsforVax .
Joined December 2013
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While you're all here and in no particular order: don't text and drive, the earth is round, vaccinate your kids, the moon landing wasn't fake, drugs aren't good for you, there isn't a cure for cancer the doctors are hiding, always wear sunscreen and vaccines don't cause autism!
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Induction summary so far; told not allowed in car park, threatened with non-payment of wages within 10 mins of opening talk, no passes ready and people wonder why there is a recruitment crisis
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A fever is a normal response to an infection. Having a fever is not diagnostic of
#sepsis
. This is a hill I will die on.
#sepsishysteria
#badmedicine
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@NHS_HealthEdEng
I applaud you for the amount of damage that you've managed to do in just 10 years. It feels longer.
#HEE10
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In a stellar PR move I've had an email from
@uhbtrust
claiming that I've been overpaid for bank shifts when I worked as a registrar because my breaks were paid.
Pay for all the time I was expected to be available was a condition of taking the shift.
@BMA_James_Steen
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@ShaunLintern
Do they have a separate poster for non strike days when the waits are no better 🤣
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The more I look at the consultant pay deal the worse it is. Does virtually nothing to address the major losses to inflation, risks the corruption of SPA time, completely leaves out the year 5-9 consultant AND ditches the rate card. Time for
@BMA_Consultants
to reject this offer.
Initial thoughts on this pay deal offer: the ones who will benefit most will be year 8 consultants and higher, ie those who are more likely to have had their mortgages paid off. The younger consultants will see much less of a pay rise than their senior colleagues initially.
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**alert** obvious subtweet: don't claim 'FRCA (or other specialty exam) equivalence' either sit the exam or stop making a fool of yourself.
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Anyone else fairly fed up with giving NHS trusts/HEE an interest free loan that it's a fight to get back every time you think about doing a course?
It doesn't work like this in other industries. Perhaps something to take on after full pay restoration is done
@TheBMA
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Do you think the GMC realises the impact of the precedent that it has set?
When have you ever seen the GMC respond like this?
If they found one resident doctor guilty of inadequate supervision, they could find any of you guilty
They realise the cats out of the bag with the precedent they have set
Protect yourself & utilise the BMA MAP guidance
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I am astounded by the deafening silence emanating from
@VictoriaAtkins
@NHSEngland
@DHSCgovuk
@DHSCmedia
@gmcuk
and any NHS trust who's SoMed I've checked.
Absolutely nothing on
#NationalDoctorsDay
I'm sure I won't be alone in taking note.
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An hour elearning on sepsis is not going to improve sepsis recognition by doctors. It will be another pointless time drain expected to be completed in our own time
#sepsismisinformation
. Not all sepsis harm is preventable.
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@AbiBosher
@TheBMA
@BMAJamesP
@BMA_JuniorDocs
@royalhospital
@LibraryCRH
@BAspinallDME
@ChesterfieldED
@CRHHumanFactors
@crhcceteam
@CRHMedicineDiv
@the_mdu
@teamsurgery
Couldn't value the new doctors enough to provide everyone with chairs?
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@BMA_Consultants
It's a really bad deal, doesn't address inflation for the last 2 years let alone since 2008. No DDRB reform. SPA changed to DCC. Consultants of <10 years almost completely left out. Reject, reject, reject.
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@EdgarMoose43433
@jobbinggasman
@AMHoste
@Dr_Done_
@mmamas1973
@BMA_JuniorDocs
@cannula_service
@Dr_BellaR
I went to Cambridge, there was some overlap very early on in things like biochem but rapid splitting of the two courses. To suggest they are the same is simply a lie.
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@ldndoc
@gmcuk
@drcolinm
By which point the PA is on £47k (band 7 progression from NHS Employers website) and the doctor only out earns if they have been lucky enough to get straight into training with the bottlenecks and have reached CT3. That's before considering student debt, indemnity, etc etc
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@EmergMedDr
@silv24
In my experience they don't think we're doctors about 1/2 the time. It's a massive plus because it means people are less inclined to recount their entire medical history at a social engagement!
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Is the SJT just priming the next generation of doctors to accept being bullied and abused by the system?
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I'd settle for everyone having been released to do their ALS
@scrivvyfloor
@pcricoarytenoid
@ABarotchi1
I think any medical trainee carrying the crash bleep needs to be able to manage an airway and insert a central line.
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@DrGoblin3
If pt has appropriate support at home, feels like he's improving and not postural is there not a role for high quality safety net advice alone?
(DOI intensivist so GP very much not my bag)
Maybe withold the ACE/ARB whilst symptomatic?
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I predict harm from sudden reversal of anaesthetics. IMO likely to increase distress with a sudden increase in pain and noxious stimulus not masked by the final washout of prop.
A nice mellow wake up with no poking/shaking/shouting is a skill that's a glorious thing to watch.
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@inpsychfulminds
@noodles_nood
Shouldn't we be trying to make foundation training less terrible rather than advising people to suck it up?
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Waiting for the community note
As Secretary of State for
@DHSCgovuk
my duty is to patients, and I want to pursue all avenues to resolve the dispute with
@BMA_JuniorDocs
.
I’m pleased the Committee has agreed to explore mediation, and I am hopeful that this will provide a way forward.
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Waiting for everyone to jump in and claim this isn't a problem
Overheard PA students
"Our PA training is intense, essentially doing what medical students in 2 years"
"No one wants to do F1 F2 jobs, just pure service provision. They have no choice. Our first months will be like that until the consultants notice us & let us do regs stuff"
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@TimothyEdenRD
Just tell them to actually read the 2016 T&C's. They can't ask you to work an on call without an induction and they can't make you do a swap. It's their responsibility to arrange clinical cover for the relevant area until you've had your induction.
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@ShaunLintern
However, there are actually a few very clear boundaries in place that have been ignored.
- representing yourself as a doctor when you're not
- prescribing on other people's logins
- at least one hospital widespread requests for ionising radiation
#PAproject
must be paused.
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A decent portion of the so called 100 hour week was down-time or sleeping so let's stop comparing. Also free accomodation, not forced to move around all the time, better salary, food etc etc etc
@hayleymagill
I've been a doctor for 32 years...was one of those on 100 hour weeks in the 90s. I didn't get into this for the money
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@MartinBromiley
A CXR is definitely not the investigation of choice for aortic dissection.
The CXR may be normal with a confirmed dissection and I'd imagine other causes of a widened mediastinum in a 22yo are also far more common than an aortic dissection.
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@trentconsultant
I voted no. For me the DRB reforms aren't clear enough and it doesn't make a clear enough path to FPR.
As an aside I'm still disappointed in CC for putting an offer with a small pay offer, an SPA raid and a LTWP clause in it to the membership.
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@AHill_PlymUni
@FPARCP
For the role of GP they are absolutely less qualified than the consultant of that specialty who is supervising them.
The fact that these particular PAs have not highlighted that they were working beyond the scope of their role is deeply concerning for their probity.
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Because
@RCPhysicians
don't actually want the data?
I’ve heard concerns from trainees about an
@RCLondon
visit to a large teaching hospital.
Trainees & PAs were grouped together for questions about training & trainees asked to give feedback on working with PAs while in the same room.
Totally invalid data.
Why
@DrSarahClarke
?
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@sallydavies27
any idea where
@DrBruceKeogh
is hiding now that there is an actual NHS crisis not just
#juniordoctorstrike
?
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Boom. That is how you tweet about your pre-hospitsl job. Non specific and delivers a message. Plus no identifiable cars in the picture. Other services take note!
The Magpas Air Ambulance advanced medical team have already been called to two serious incidents this morning.
Please take extra care on the roads and stay safe in the poor weather conditions today.
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@MartinBromiley
A very tragic case but I do think it's unlikely to be reliably preventable in future by a radiologist review of the image with appropriate supporting clinical information like 'chest pain following sports'.
This is obviously with the caveat that I'm not a radiologist.
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This should encourage all junior doctors to return their ballots asap
Sorry to see that
@NASUWT
members won't be able to strike because of the turnout thresholds. It is not enough to get a majority with our oppressive trade union legislation. Lots of work to do to mobilise
@BMA_JuniorDocs
to
#JoinVoteWin
#PayRestoration
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@drcolinm
@DrLindaDykes
@DrLKVaughan
Perhaps the GMC could have been more proactive in defining scope or suggesting an alternative regulator rather than a halfway house we currently have and also questioned whether the suggested format of 7 digit registration numbers is appropriate.
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@jayghosh27
@wesstreeting
More important if you ask me. More recruitment won't provide a useful output for 6 years at least. 10+ years if we're talking registrar level even if you rid of the current training bottlenecks.
If you stop losing the doctors you already have they work right now.
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@willtube4food
If so worried about hitting something that routinely checking lung sliding before and after feels necessary I might politely suggest the operator needs support with their technique.
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@laurevans311
This has been a major talking point on the picket, it has helped non-medics understand what we are paid. None of the discussions I've heard about it have been negative
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@Anongas33
I don't understand why the educationalists thought it was a good idea to split the run through programme
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IMO intubations/inductions on ITU are only 'easy' retrospectively.
Even re-intubations may have developed significant oedema since their presentation becoming tricky.
Anyone involved in airway management needs to appreciate this and there needs to be a robust plan for failure
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@EdgarMoose43433
@jobbinggasman
@AMHoste
@Dr_Done_
@mmamas1973
@BMA_JuniorDocs
@cannula_service
@Dr_BellaR
Nothing that I've said is arrogant, the degrees are simply not the same. It's like saying that someone reading history is a geographer.
I've never minimised the knowledge and work of a NatSci student and I was delighted the pre-clinical topics are taught by expert scientists.
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Peri-CCT has meant a trawl through emails looking for documents.
I've been reflecting on all the hurdles that doctors in a specialty training programme have to jump through.
Some sensible/necessary, many poorly designed systems, some simple incompetence.
We need better.
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@DrLKVaughan
I've not been able to find any description of misconduct here. A mistake yes but we are humans working in a system under terrible pressure. What does the GMC think it's doing?!
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@AjayMVerma
@ReginaNolan1
@RCPLondon
It's not good enough. One of the reasons so much time elapses between interviews and offers is so that there is enough time to get it right first time. They've already had the chance to get it right and failed. People make life decisions based on the offers.
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@NadineDorries
@DailyMailUK
For a start £500,000 is a ridiculous estimate for an FY1. However, if it cost that much isn't the logical next step to make pay and conditions good enough for doctors to want to stay? £19/hr for a doctor isn't expensive.
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@EdgarMoose43433
@jobbinggasman
@AMHoste
@Dr_Done_
@mmamas1973
@BMA_JuniorDocs
@cannula_service
@Dr_BellaR
Like I said there's some overlap but alongside physiology doctors study anatomy, pharmacology, pathology etc etc etc
A NatSci doesn't study medicine. If they follow a biology theme they will end up studying one part under the broad topic in incredible detail.
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@NoStaticAtAll
Perhaps if you don't feel skilled enough to temporarily cover the role of a Junior Doctor now would be the time to request some additional training?
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Why is Pulse acting as a mouthpiece for UMAPs?
UMAPs argued that it is ‘inappropriate’ for the doctors’ union to ‘unilaterally redefine and attempt to impose a scope of practice on another profession’, and highlighted a lack of ‘stakeholder engagement or peer review’.
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@laing_simon
@wmasadamlote
@OFFICIALWMAS
think this is a perfect summary of the issue. You may believe you conforms to guidelines, many don't. You don't see this from any other AHP group and many people, me included, believe patients will be able to identify their own stories and they aren't yours to tell
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@djnicholl
@PreetKGillMP
@uhbtrust
@unisonwestmids
@TheBMA
@BAPIOWM
@BHPComms
@NHSMidlands
@edgbastonCLP
I think the interesting question is whether the threat was made not whether there is a realistic chance of a negative ARCP outcome as a result of the strike.
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How have we got to the point where parking a bus like this is acceptable
@nationalexpress
@birmingham_live
@BhamCityCouncil
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@Anaes_Journal
Direct laryngoscopy is still an essential skill that needs to be maintained. There are situations where video laryngoscopes are not available or not suitable. E.g. the heavily soiled airway in a ward environment.
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@VictoriaAtkins
@VictoriaAtkins
you're very behind with your knowledge of doctors, their working patterns, their contracts and their skill sets.
Will you be using your Christmas and New Year break to catch up?
P.s. so you know for next time
@LBC
ask, PAs are paid around 35% more than FY1
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.
@TomStocks1982
@ERunswickBMA
@RobLaurensonD4P
I imagine there are also lots of other people affected.
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@DrLindaDykes
In my opinion it's worth some attention from
@TheBMA
and
@BMA_JuniorDocs
making sure that is not a sign of a problematic culture at
@NTeesHpoolNHSFT
and that Junior Doctors are being treated fairly.
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@VirtueOfNothing
@Dr_Done_
Equally, just because one person hasn't seen it doesn't mean it never happens.
More information is required.
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First session out at a very wet
@RockinghamUK
in the
@ResusCouncilUK
Ginetta G40
#WeAreGinetta
#Ginetta
. Getting ready for the
#GRDC
supporting
@BritishGT
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This almost perfectly summarises why a career in ED was not for me.
Clinically it was varied and interesting but I just could not put up with the schedule.
The impact of changing to a 'casino' shift style rota system.
Casino shifts maximise the time you are sleeping between 0100 and 0600.
Early results (based on data recorded from wearable sleep monitors in 8 subjects) show an improvement in sleep quality and risk.
#PAS2024
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@doctorhelgi
@DrKidneyAsh
#bekind
is not the answer to that kind of disgusting and degrading behaviour.
Yes there may be issues that the individual is experiencing and in need of support for but that is not an excuse and should not be used as such.
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Just say no. Can always be done on the first day.
But yes, lead employers would be wonderful!
4 and a half hours on my day off to get some ID photocopied and my blood taken.
If we have to rotate every 3-6 months, have the decency to be a lead employer.
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Awful example of what happens to rotating drs when permanent staff don't support them/ are actively cruel. Non-rotating health workers: please challenge toxic behaviour in your departments. Culture is everyone's responsibility.
NB OP overwhelmed by response so username removed.
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@NatashaMDay
@DrAliJSmith
@simontutt88
Paramedics in GP are supervised practitioners no?
Paramedics independent in the pre hospital role yes but surely the context for this is completely different.
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Preparations complete
@uhbtrust
for the
@ResusCouncilUK
#RestartaHeart
day.
#lifesaverVR
#lifesupport
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@thomaswoodcock
@TheBMA
Tom, you must've known this was completely disingenuous when you wrote it.
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@DacreJane
@DHSCgovuk
It's all on
@DHSCgovuk
anything else would be disingenuous,
@TheBMA
have been trying to get them to talk since the middle of last year.
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@take__AIM
PAs are paid more per hour than everyone up to senior reg. Why are the PA fees lower?
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@BBCHughPym
oh and the fact it must be pay neutral for more antisocial hours. Calling a spade a rose does not stop it being a spade.
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Balanced thread on why we need to stop scope creep and support the training of future consultants.
I'm a consultant interventionalist, but was a trainee just 18mo ago. I am an educational supervisor (to doctors) and have mentored ANPs & pharmacists to expand their skills. I am clinical lead for my department, so all too aware of the pressures on trusts. Here are my thoughts.
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Hi
@doctorhelgi
I was also at the meeting. Unfortunately neither of my questions were actually answered making the
@RCoANews
position increasingly unclear.
@StevenMAlderson
@RoshanaMN
@Dr_Done_
@totalguff
I do think private chats have a role - useful for me to gauge opinions and conveys much more than 280 characters - particularly when so much anger is expressed.
I think accusing us of not engaging is unfair. Also HEE brought in AAs, no college money has gone into developing the
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@ShaunLintern
@Jeremy_Hunt
Utter rubbish I'm afraid Shaun. No focus on evidence, no engagement with staff on safety. Funding down in real terms, waiting times up. Winter crisis extending into the summer.
@Jeremy_Hunt
was all grandstanding and no achievement. Good riddance.
#NHS70
#saveourNHS
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@Bonivorlewis
@Xeon4f145d96s1
@floshiiiekn
@TheAnonymous_PA
Because a day 1 PA is less trained than a day 1 FY1
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I've said it once and I'll say it again, chiropractice is dangerous quackery.
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You are highly trained professionals.
Be civil and respectful but also expect to be treated with civility and respect.
If you're not, escalate it.
#TipsForNewDocs
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Siri, show me problems with the NHS
@Naomimiii
@KatPaton13
Right. Thank you for proving the point about issues with hierarchy in the NHS. My advice is be respectful, bring the nurses and HCA’s food and you may have an easier time. But with your current attitude I wish you all the luck with getting any help from anyone
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@Alexandra_nidd
Small claims court? When they start getting CCJs it looks bad and they'll start taking notice
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Where are all the PAs proclaiming that they aren't trying to be 'equivalent' now?
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Further evidence of permanent staff bullying junior doctors. Note, consultants are not excluded from the staff room.
If you are a consultant in a place like this it is your responsibility to challenge this behaviour
From juniordoctorsuk subreddit. Interesting to see what the reaction is of those who felt the mess should be for everyone…
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