Thomas Shanahan (Dr.) MRCEM
@clifford0584
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(PGY7) ED Registrar @ Royal Melbourne Hospital | Associate Editor CCR | EMJ Update Monthly Top 5 | EM researcher. Ex-UN. Husband🏳️🌈🇮🇪🇬🇧 views mine
40y. Manchester, England
Joined September 2011
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Really excited to have been offered and accepted ED
#research
registrar job at Royal Perth Hospital starting Feb 2025. I will be supervised by Prof Fatovich. Focusing on older peoples major trauma with data from UK, Victoria and WA.
#emergencymedicine
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Wow ambulatory care was fun today with the 100th post AZ vaccine headache, rule out CVT.
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This is my 6th year of being a doctor. I will have worked Xmas day 4 out of 6 years (including my Mums last). Only reprieve was academic block & anaesthetics before IAC.
Doctors should be more valued in this country. We work hard and we care.
#NHS
Merry Christmas 🎄
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Today is the day of cancelling:
- Phone contract
- GMC registration but keeping licence to practice
- BMA (once strikes conclude)
- Various other subscriptions
And bank account open and card arrived for Australia
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Only been on gastro 3 days, but every day after the ward round reg or consultant bought Costa coffee for the team and we had 10 mins to drink it, chat and talk about the jobs. Small things matter. Culture matters. And it’s a very busy service. Feeling part of a team matters.
Today I found our new junior dr eating lunch at 4:30pm.
This is NOT ok.
Give your juniors permission to look after themselves. They shouldn't need it, but the system means they do.
I will now make it my job to make sure she eats on time.
#FOAMed
#medtwitter
#burnout
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Just to put into perspective my 80% LTFT rota will pay me £57,859 for 37 hours a week on average (total)
My 38 hours a week with 5 paid hours of education a week in Melbourne will pay basic salary of £70,350
This does not include OOH, salary packaging, CME pay
Why leave? 🤔
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What a stupid post
@gunsnrosesgirl3
the 12y old kid that successfully intubates faster than the best paramedics
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My lovely Mum (60y) died today with myself and my sister by her side. The care she received by all the team at Beccles hospital was outstanding.
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Phew! Come August 1st I'll be saying. Hello, my name is Thomas, I am one of the junior doctors in A&E how can I help you today?
Thanks for all the love and support from family and friends over the last 7 years.
Excited for what come's next
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Payslip number 2 in 🇦🇺
This was for a fortnights work. I only did 66 hours (33 per week).
Net AUD$5251 = ~ £2711
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Anger as record number of NHS doctors quit for Australia pay boost
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Official resignation from the U.K. EM training today. Big decision. Feels right for the now and long term.
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Surgical registrars just in case you forgot, you’re job isn’t to belittle and make your FY1s cry and not want to come into work. So much power, use it wisely
#dontbeadick
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Pay slip number 3 in 🇦🇺
Fortnightly pay = AUD$5711
= £2,952
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I’m sorry but when a manager comes in to the ED with a face like thunder, huffing and puffing when looking at over night numbers, not helpful for the old morale of the
#teamnightshift
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😂😂😂
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My basic salary at ST4 equiv in 🇦🇺 will be £69,984 (compared £55,328 here)
Then factor in 38hr wk, penalties for nights & weekends, study leave (CME) payments, salary packaging, 5 hours a week paid education, 5 weeks AL, 1 week study leave (maybe more & some extra courses) etc
⬆️ Junior doctors will get a pay rise of between 8.1% and 10.3% depending on where they are in their training.
This is a fair and reasonable increase as recommended by the independent pay review bodies.
Full details below 👇
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Happy 8th anniversary (13 years together)
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Provisional registration with AHPRA all finalised ✅
All paperwork done for the move to Australia 🇦🇺
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Really not built for anaesthetics - maybe it’s being a novice. But it doesn’t fit my personality at all. I like to be busy, and don’t really appreciate daily sitting around, loads of breaks, loads of dead time. Feel more tired at end of shift than when working in the ED.
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Why are you on TV? Are you a BMA rep? It begins again…
I was on BBC News this afternoon talking about the possibility of NHS strikes. No one wants to strike but if this is what we have to do to protect our patients and ourselves, then so be it.
#SOSNHS
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Everyday is challenging
I came on to 200 in ED last night. No strikes. What are you lot doing about it?
#emergenycare
is collapsing. Corridor care should be unacceptable. It’s unsafe and undignified. Honestly you need to do better all of the
#NHS
“leadership”
A hugely challenging six-day stretch awaits, the likes of which none of us have ever experienced. Thank you to each and every team member making significant personal sacrifices to keep patients safe, and to anyone considering accessing care please listen to
@NHSEnglandNMD
🙏
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Being ED lead clinician overnight in a department with no flow, 140+ pts, 40-50 waiting for beds (often not clerked by specialty, needing 2b handed over & making sure nothing is missed, getting right care), giving advice, check ECG/VBG/X-rays, firefighting - is draining 💤💤💤
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Pay slip 4
I did 8 shifts this fortnight (76 hrs)
3 weekend nights
2 other weekend shifts & bank holiday
Pretax S.Pack Max is salary packaging. Goes into my account as well
Net AUD$7369 = £3811
7 weeks pay $25,797 or £13,340
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Why are junior doctors calling for pay restoration separately from consultants? Surely this should be a joint campaign - all medics?
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What is the logic of starting a Dr on night shifts in a new place?
Feels any easy win to start in a new place with seniors/consultants around for feedback & to get to know the new place, how it works, IT, systems and people.
Feels like a marker of an org that doesn’t care
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Manuscript accepted for publication
Great way to start the weekend
😀🍾🥂🥂🍹🥃
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Really excited & humbled 2b offered 5 of 6
#ACF
in
#emergencymedicine
I applied 4.
My husband & I have decided on Manchester.
Now I have 2 prepare 2 & make sure I do well in the ACCS interview process. Then we can start looking 4 r new home.
Txs 2 all who advised me on apps
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Why are we telling people no eating from 2am and clear fluids up to 6am when they are last on a day case list for a procedure using local anaesthetic? Husband now waiting since 8am for an operation with no food or fluids all day. Not good enough I’m afraid. Not patient centred
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ST3 ✅
On to ST4 for 6 months then Royal Melbourne Hospital for ED registrar job
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Grandmother died, Mother very unwell and in hospital, Nala (dog) unwell again overnight.
Life is a bit meh at the moment…
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Got offered clinical place at MRI, alongside my ACF in Manchester (clinically benchmarked). Very happy. Can’t wait to start academic training in
#emergencymedicine
in Manchester.
#ACCS
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👋 👋 👋
Now for some good food and drinks and sleep
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First week pay in 🇦🇺
Context it inc. being paid for orientation & EMR training & salary packaging fringe benefit finishes 31st March so I have a couple of months of low tax.
Net pay AUD$3737 (~£1937)
Will share more over next few months as comparison with
#NHS
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After the last few weeks of paper rejections and tough time with family stuff nice to find out tonight I’ve been shortlisted for the
@RCollEM
and
@NIHRresearch
young researcher of the year award. Look forward to presenting my proposal at the research engagement day 14 Jan 2022
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What a week - 39th birthday; 11th civil partnership anniversary & accepted an ED registrar job at Royal Melbourne Hospital. Start Feb 2024 as an OOPE.
Really excited, can’t wait 2 make the move & have a new & diff EM & living experience.
Now for the paperwork… & celebrations
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Does anyone like the ICU or medicine long days or nights (12-13 hours)? Much prefer the short ED shifts. I would do more days than more hours in a day. Decision fatigue and tiredness. Lack of any down time is a killer
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ARCP outcome 6: completion of foundation programme
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#MRCEMPrimary
✅
So happy to pass. Feel very proud given the context; ICU rota; was feeling very unwell at the time; and dealing with my Mums illness and Nanny passing away.
Now to the next one…
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I’m all for the Royal Colleges being supportive of or promoting the role of PAs and ACPs - but can you also support your trainees, SAS and consultant Drs. It’s quite tiring at the moment how little support is coming in our direction & blurring of roles & responsibilities
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3.5 months until moving to Australia
Coming around very quickly
Exciting and a little apprehensive - new place, new culture, new ED and way of working and the challenge of going alone
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Junior doctor strike had unprecedented NHS impact
That’s kind of the point
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She should not be on the news. She has no mandate. I can’t say more but it’s terrible she is given a voice
🚨This is
@EveryDoctorUK
's
@JujuliaGrace
on BBC News. She's a tireless advocate for the NHS and this is an excellent interview. Please watch!
#SOSNHS
#ReviveTheNHS
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It’s interesting how valuable these are - nothing is ever said so positive about foundation doctors. Why?
Physician associates support the wider clinical team, reduce workload pressure and enhance patient experience.
The NHS Long Term Workforce Plan sets out how to build the right staffing and skills mix for the future, including expanding roles like these.
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Threatening a Datix is a thing it seems 😔
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@davidderbyprice
@Jeffers0846
@PaddyMcGuinness
Nope you are wrong. Medical students are unpaid, they are having £100K debts instead. When you finish medical school you are a qualified doctor. That’s the quoted pay. Then you cd be training to be a GP or consultant or specialist for 5 to 10 years & more if doing extra things.
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He’s a crank
Karol Sikora: Meet the Professor of Positivity we should all listen to during coronavirus pandemic
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I love my job and new Department, but I must admit easily the biggest negative of starting a new job, is the complete lack of social interaction. It’s weird to not be getting to know colleagues socially. Bloody
#Covid19UK
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Nice to get an interview for an EM registrar job in Australia. And I’ve had some really good conversations about possibilities. 🤞
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£2.9K a month after tax for an ST4 (including LTFT allowance, FPP) doing 35 hours a week (80%), opted out of pension and minus 1 day for IA
It really isn’t very good pay is it?
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So where in Oz are open to U.K. emergency medicine registrars with an interest in major trauma research?
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I now appreciate why sorting out a pulled elbow is a favourite of PEM Drs
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I know this comes from a good place - but just no. Sorry those things should be a given. Pay is key to this dispute. Not secondary or placated by our employer just doing the basics properly. The lack of the basics is why the NHS is a terrible monopoly employer
Another
#juniordoctorstrikes
comes to an end and we seem no further forward. It is clear that the figure of 35% raises antibodies on all sides and beyond. Perhaps it’s time to try to think of other ways forward?
@_VivekTrivedi
@SteveBarclay
🧵1/9
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Husband has left 🥲
Great 3 weeks
Thankfully only 6 weeks until I’m back in the U.K. for my 40th
Then it’s planning to move to Oz and make things permanent - exciting times ahead
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Don’t give stat doses of amlodipine for hypertension
Treatment and Outcomes of Inpatient Hypertension Among Adults With Noncardiac Admissions | Cardiology | JAMA Internal Medicine | JAMA Network
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Oh my God I finally understand what good pay is again. Caps off a great few weeks in Melbourne. Being paid for my first week of work was such a lovely surprise 😀
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No I won’t be changing to anaesthetics, like everyone else. Yes I’m very happy with my choice of emergency medicine and research. Thanks for asking 😀
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First wave acute medicine, second wave emergency medicine, third wave intensive care. Yippie
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My husband is officially a UK citizen. Took two months processing to get settlement and now took only two months to process citizenship application. We have been luck (and well prepared for the process)!!! Wonderful news on a day of less good health news for a family member
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Junior doctor strikes ‘will go ahead unless there’s a serious offer on table’
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I must admit I’m kind of surprised at the amount of us self-described working class medics on Twitter. Seems disproportionate to the reality of the profession. Is Twitter a good space for diversity in the medical profession? 1 positive at least
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Emergency Departments really are the only place in healthcare that are seen to have elastic walls and can keep taking on the system risk.
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Really pleased to share a paper published in Injury.
It is an external validation of a Dutch prediction model for identifying major trauma patients.
Co-authors
@CarlMarincowitz
Prof Sheldon, Gordon Fuller, Emily Turton & Fionn Quilty
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V pleased 2 share a pre-print of an article:
The changing
#majortrauma
disease burden from low falls in the first two decades of the 21st Century; a longitudinal analysis from the largest European Trauma Registry
@TARNaudit
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For those asking plan is to stay in Oz permanently. Enter ACEM training in 2026, hopefully with recognition of prior learning for UK training. Locations - Melbourne or Perth. Depends on being able to get 482 visa.
Official resignation from the U.K. EM training today. Big decision. Feels right for the now and long term.
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FY programme finished ✅
Home safe ✅
20,000 miles commute over 2 years ✅
Bought a house ✅
Start emergency medicine training and academic clinical fellowship tomorrow at
@MRI_ED
Now for some sleep after 12 hour shift and 2 hour drive 😴😴😴
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PAs aren’t the same as ACPs and don’t conflate the two. It’s disrespectful to ACPs
While the mind-numbingly repetitive narrative continues, thousands of ACPs & PAs get on with the job daily, without fuss, often in stressed environments, contributing hugely to patient care, education & service improvement.
The dire state of the NHS is not of their making.
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Very hard seeing my Mum in the hospice. But she is being well looked after. Have to just take it day by day. Staff looking after her well. Palliative care team have been fantastic. Now heading back home to Manchester.
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Very happy to hear today that
@126Liam
and I have got our first research grant as ACFs in emergency medicine. We will be looking into the experiences of EM ACFs over the last few years. We’ll be working with a great team
@richardbody
@EMergeMedGlobal
@vfjn2
@BeckstaylorFish
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Today I will celebrate the life of my wonderful Mum. It’s the 2nd birthday since she died. I miss her every day. This was us together in 2012 at Bondi beach before my civil partnership
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Just thought I’d say as it doesn’t seem 2 ever b said - I’m in training, in an ED & the rota is actually pretty good. Opp for leave, study leave approved, changes to attend ACCS days and ACF sessions. 11 nights; 14 twilights; 9 weekends in 6 months. Clinical Director manages rota
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Stop withholding contrast
A 38-year-old black man died at
@NHSBartsHealth
after a flawed decision to sedate him. Coroner criticises "coping culture" and the trust response including governance failures and poor effort by lawyers
#patientsafety
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This week brings new challenges.
No longer an academic trainee. Finished
@NIHRcommunity
ACF.
Going LTFT (80%) for the first time.
Starting higher specialist training as an ST4 in EM in Blackburn.
Counting down to OOPE ED Reg at Royal Melbourne Hospital
~55-60 shifts to go
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See what EveryDoctor has done - you can see the narrative of Drs being linked financially with masks diluting any public health message about mask wearing after July 19th. They are a menace. All those RT and supporting them is part of the problem.
#COVID19
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My outgoings for rent (2 bed apartment in Collingwood), electricity, phone, TV services, internet, travel, health insurance, HelloFresh, indemnity, groceries, going out is approx AUD$4K a month and salary is AUD$10-11K net. It’s manageable to live here. I didn’t save in U.K.
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Why don’t big tertiary MTC hospitals have a surgical assessment unit that post-op patients can go to if they have a complication. They should have access to x-ray/investigations and advice via on-call teams. Don’t tell them to go 2 ED - it’s not the right approach 4 crowded EDs
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I know random people on here & real life like to judge the decisions we make.
But it’s worth putting it out there that the antecedents of the decision to try out Australia was my Mum being taken from me at only 60y of age & in horrible circumstances.
A new life & opportunity
Provisional registration with AHPRA all finalised ✅
All paperwork done for the move to Australia 🇦🇺
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Could definitely get used to city living again (it’s been quite a while since I lived in the heart of a city).
Got the keys to my apartment today. Moving in tomorrow
This is the view across to the brunch place I just tried - very nice
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Why r patient safety advocates silent about what is happening right now in EDs, hospitals & GP surgeries across the Country? Really odd 🤔
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Very pleased to be appointed
@NIHRresearch
Associate PI for
#RECOVERY
trial at
@MFT_MRI
. Look forward to continuing to help with the trial that has helped find mediations that work for
#COVID19
@EMManchester
@richardbody
@timwfelton
@MartinLandray
@PeterHorby
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There is good evidence that overcrowding in emergency departments and long waits (and no doubt ambulance delays) result in excess deaths. That has little to nothing to do with strikes. Its lack of money, staff, beds, and poor operational processes to improve flow
#NHS
The front page of tomorrow's Daily Telegraph:
'Record number of deaths amid NHS strikes'
#TomorrowsPapersToday
Sign up for the Front Page newsletter
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What a wonderful day saying goodbye to my Mum and celebrating her life. She was the kindest, caring and most loving Mum anyone could have wished for ❤️
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Can’t believe 6 years of medical school and access to medicine are complete (hopefully 🤞)
Day 2 OSCE felt much better than day 1 OSCE. While to wait to find out about sequentials or passing
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First shift tomorrow night as PED ST3. Very nicely department have an extra registrar on. Appreciate the support. Big year ahead in intermediate role as registrar (most senior overnight in PED) & paediatrics after being away from ED for 18 months. Nervous and exited
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