Lasantha Wijesinghe
@ldwijesinghe
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A medical student joined me in theatre today. She inserted a cannula, intubated the patient, set up IV fluids, urinary catheter, incised a stitched a wound, assisted for a fem-distal, and even liked my play list. She might be back.
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The great Harold Ellis is finally retiring aged 94. I doubt he ever took a formal teaching qualification but to me he was the best. I count myself lucky to have worked for him. Thoroughly decent, generous and kind
@RCSnews
@RCSEd
@rcpsglasgow
@ASiTofficial
@RouleauxClub
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1K
Covid data 'exaggerating' risk, medics and academics tell Boris Johnson
@FatEmperor
@MichaelYeadon3
@ClareCraigPath
@FraserNelson
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This is
@Tom_the_Baker
who was recently our F1
@uhd_nhs
. He wants to do vascular surgery. While F2 on the stroke unit he got permission from his consultant as the unit was quiet to come to theatre. So I took him through a fem endarterectomy.
@RouleauxClub
@VSGBI
Do vasc surgery.
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Oh well! Another of our former F1s has got an interview for anaesthetics. She would have been a fine surgeon. I think all the procedures she did as an ICU F2 clinched it. If only trainees had exposure to operating at F1/2 more might choose surgery
@RCSnews
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At last a debate! More important than who won was the fact that both sides argued eloquently with conviction and without the puerile disdain for opposition or namecalling that we see too often.
@LaylaMoran
@lfspinney
@pwhitakerwriter
@toadmeister
@TiceRichard
@SirGrahamBrady
The Lockdown Debate is tonight at 8pm!
@TiceRichard
,
@SirGrahamBrady
and
@toadmeister
will argue proposition while
@LaylaMoran
,
@lfspinney
and
@pwhitakerwriter
will oppose.
Open to all to stream on Youtube at
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Launched
@vsgbi
this week. A new book aimed at students, F1s and associated professionals. Totally free thanks to VSGBI
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Yesterday I had a lovely day at work. First our trainee replaced a popliteal aneurysm via posterior approach. Then the medical student doing anaesthetics got bored with gassing so he scrubbed in for the next case and now wants to be a surgeon.
@rcsnews
@UHD_NHS
@RouleauxClub
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A thoroughly brilliant occasion. The Diplomates' ceremony
@rcsnews
Celebrating with a vascular group
@VSGBI
@RouleauxClub
@HannahCTravers
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If consultants to get pay restoration it will not be only for ourselves, but for our trainees, future consultants, who did not have student grants or free accommodation and will find childcare, mortgages and other expenses much more difficult without it.
@TheBMA
@ASiTofficial
Consultants: yes they’ve mostly fixed your pension issues.
But your real pay is still down 35% and rising.
If/When you get your chance to vote for strikes next month, remember this photo. Remember what they think of you. Reclaim what you’ve lost.
@trentconsultant
@Vish_Sharm
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Welcome to my new colleague Miss Mary Weisters who was appointed today as consultant vascular surgeon
@UHD_NHS
@MWeisters
@WomenSurgeonsUK
@VSGBI
@RouleauxClub
@SouthWestVasc
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@halseyhands1
@OrthopodReg
Yes this all seems very unfair and probably unnecessary.
Some aspects of the old days were better - it was generally expected that we would apply for jobs in the hospitals and firms where we’d been students. Usually, but not always, it worked fine.
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Very fortunate to be working in a hospital with a facility like this. Great for a quick coffee between cases or just for a chat. Also good for patients to relax away from the wards. Always sunny in Dorset (misinformation).
@UHD_NHS
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Prof Cliff Shearman has been awarded an OBE for services to vascular surgery. Wonderful for him and great to see a vascular surgeon and recent RCS England vice president in the Queen's Birthday Honours.
@VSGBI
@RouleauxClub
@RCSnews
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Usual kind of on call today including acute leg ischaemia, diabetic foot, and infected graft. But the most satisfying success was replacement batteries for a patient's hearing aids. Thanks to ward clerk Kimmi Nakano
@UHD_NHS
for sourcing them.
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Doing the F1 job today reminded me how hard my junior colleagues work and how much the job has changed but also remains the same. I'm tired and I didn't even have the elective work to deal with, but I am 33 yrs older. Good luck to
@Doctors_Vote
@BMA_JuniorDocs
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21.4% of 5,764 UK surgical trainees responded
only 143 thought PAs had +ve impact on training, especially efficiency of ward work and continuity of care
924 thought PAs had -ve impact and this was in reducing access to theatre cases and to training opportunities in theatre
📢 New
#ASiT
Report on Physician Associate Impact on Surgical Training and Patient Care 🏥👩⚕️
🔍 Largest ever ASiT survey: 1,978 doctors across all surgical specialties in the UK.
🤝 Focus: Physician Associates (PAs) impact on surgical training and patient care
📈 73.8% worked
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Interviewed 2 top trainees today. 1 from Ghana the other S Sudan to replace our old one. The
@RCSnews
ISTP scheme brings trainees from LMICs to UK for 2 yrs to train and take their skills back home. The College does all the paperwork. Easy.
@ASGBI
@BAUSurology
@VSGBI
@bota_uk
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@MichaelYeadon3
@CJforeveryoung
@grahambradymp
Thanks Dr Yeadon, you and others including myself keep trumpeting the point about FPR yet nobody in SAGE or gov’t seems able to reply. They either don’t know, or they do know but don’t want us to know.
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Nor will it acknowledge that people such as
@ClarkeMicah
@DrJBhattacharya
@AllisonPearson
@toadmeister
who were critical of lockdowns were vilified, sidelined and disparaged by the very parties who now lament the outcomes of those policies.
A damning report on the impact of lockdown on poverty, socio economic outcomes and mental health - with a quarter of older children impacted. This is what the covid inquiry should be addressing
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Nikolai Volodos 1935-2016 emigrated to Ukraine where he pioneered aortic stenting before Parodi and patented Z stents. His reports in Russian were missed by western surgeons reading English journals
@VSGBI
@ESVSmembership
@RouleauxClub
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@bmj_latest
@aneezesmail
No! PAs are not medical workforce. They are non-doctors who assist doctors - we wouldn't call an advanced nurse practitioner part of the medical workforce.
Widen participation? Yes, but properly, by funding people of all backgrounds to study *medicine* in medical schools.
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2 cases. Femoral vein to replace mycotic aortic aneurysm and excision of carotid body tumour. Shame there was no trainee at either. Come on
@RouleauxClub
why not come and work at
@UHD_NHS
?
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Prof Frank Smith and I had the privilege of being at the Diplomates' ceremony today and to see vascular surgeons Eleanor Atkins, Terri-Ann Russell and Nadeem Mughal receive their FRCS
@VSGBI
@RouleauxClub
@RCSnews
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Should I accept bribes from my Operational Support Manager for covering on call on Friday afternoon? Trouble is she knows I love Dairy Milk.
@UHD_NHS
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Seems
@jeffreyatucker
has got to the crux of it:
'each time the promise has been nothing but a foreshadowing of another layer of compulsion.'
This is an appalling and unthinkable amount of compulsion to impose for the sake of a vaccine that the willing have long ago accepted and about which the remainders have either grave doubts or hard-core opposition.
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This was sent by doctors in NI responding to a call by their BMA to intensify lockdown
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BJ Waltho retires. What a phenomenal woman, nurse, organiser, actor, encourager, friend. I shall miss her and
@UHD_NHS
will be the poorer for her departure. Please more managers like her who know what it takes to care for a patient.
2) 'Some nurses are going to food banks - we absolutely deserve better':
@andym_echoes
speaks with
@bjgw
as she retires after five decades on the NHS frontline.
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@Jcalcolado
I agree. This also applies to the surgical take where patients no longer have just small bowel obstruction or just a femoral embolus, they come with a whole host of medical, social and frailty problems. The job is harder.
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David Beckett my great friend and IR colleague training SpR
@AndrewNickinson
on an EVAR he planned himself. This model works for us as IRs and surgeons collaborate.
@vsgbi
@BSIR_News
@RouleauxClub
@TraineesBSIR
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Disappointed to read this review and learn that I am mortal after all.
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Just finished an extraodinarily interesting Council meeting
@RCSnews
. If only Members and Fellows not in Council could have been there. Might show you what Council does for surgeons. Should meetings be broadcast? What do you think?
@asgbi
@vsgbi
@ASiTofficial
@RouleauxClub
@bota
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Here today
@RCSnews
with Vice President and vascular surgeon Fiona Myint and great to see vascular trainee Anesha Perera receive her FRCS
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After seeing
@amolrajan
say a disdainful 'What?' to the obviously wrong answer by Trinity, I think University Challenge will be safe in his hands.
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@chrischirp
Nice idea but the vac and unvac groups were not randomised. How were HCWs chosen to be vacced? Previous covid infection would affect PCR result so how many in each group had previous covid? No proof transmission was prevented. Not as brilliant as it might look.
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@Naomimiii
You'll still need someone to shoulder the blame and stand in court when other people make mistakes. I'm not sure a surgical care practitioner or Physician's Associate would want to do that 🤔
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Could we please stop the contactless payment only rule
@UHD_NHS
? Some don't have cards or bank accounts. I've seen visitors turned back at the till and paid their bill to save their embarrassment. If worried about infection control we'd stop touching loyalty cards and masks too.
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Help disadvantaged medical students fund their 4th/5th yrs. A joint venture
#LiveableNHSBursary
@RCSnews
@NBCCCIC
Calling RCS Eng trainees and consultants. Play a charity match Aug 29 (BH Monday) at Warborough CC. pls DM me
@asgbi
@VSGBI
@ASiTofficial
@RouleauxClub
@bota_uk
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@natalieben
Thanks for taking this stance.
Have you had any conversations about the matter with
@Keir_Starmer
@wesstreeting
@UKLabour
or have any Labour peers shown interest?
I wrote to Labour Lords and had no replies.
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Interesting to view this in the light of the Danish RCT on masks.
@RealJoelSmalley
has produced a graph of NHS triage calls for Covid symptoms showing points where masks and lockdowns came in: interventions did not change the curve.
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8
19
These days more than ever it's vital to build team morale and say thanks. What better way than a night out
@ZimBraai
with podiatrist, anaesthetist, nurses, trainees, frailty specialist, vasc surgeons, even a police inspector?
@UHD_NHS
@Tom_the_Baker
@paigewilkins96
@MWeisters
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Some common sense and an antidote to much that has been in the news this week about Covid.
@theAliceRoberts
@IndependentSage
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I found an angel in the travel office called Alison. Thanks Alison
@UHD_NHS
for sorting out my parking permit in 1 minute flat when all other avenues failed. It shouldn't have to be so difficult in the first place.
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It's a ceremonial day today
@RCSnews
welcoming the new President and members, and saying goodbye to old.
The photos before *the* photo are often more engaging than the final picture itself.
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@GinnyAB
You are right but it took me a while to realise that. When I did it changed the whole way I look at my job.
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It is good to have feedback especially if it is complimentary. I am lucky to work with this excellent vascular team that despite various clinical and organisational difficulties can find time to look after these future doctors
@UHD_NHS
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Impossible to vist Grantchester and to not remember The Soldier
'A dust whom England bore, shaped, made aware,
Gave, once, her flowers to love, her ways to roam;
A body of England’s, breathing English air,
Washed by the rivers, blest by suns of home'
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5
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The 42nd
@SouthWestVasc
meeting held this yr in Swansea. Brilliant for trainees and nurses in the team
@UHD_NHS
to present their work
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@ClareCraigPath
I cannot believe what I've heard from David Spiegelhalter
@BBCr4today
. He says we need dramatic action because the NHS won't be able to cope. He doesn't seem to understand the '2nd wave' is over.
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@callum_a2
You only have to observe how many watchless, bare below elbows, non tie wearers, don't wash their hands properly, to see how it's mostly for show.
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I count myself fortunate to be in the same team as these lovely people. They make my work a whole lot easier.
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What a great surprise to see
@Naomi93720852
who was F1 in Bournemouth
@UHD_NHS
in 2017, and to be officiating at her MRCS Diploma ceremony today
@RCSnews
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It is always nice to receive a thank you from a trainee. This shows how much the whole team of consultants is involved in developing the consultants (and colleagues) of tomorrow.
It's been great having you with us for a year.
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Another interesting one from
@BrennanSurgeon
's group in
@RCSnews
Bulletin. The obvious error here is they forget to mention how much nicer vascular surgeons are when compared to other surgical specialists.
@VSGBI
@RouleauxClub
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1
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'How can we maximise operating theatres and reduce waiting lists?'
How about letting staff go home if they manage to finish the list early? Amazing how so many say this incentive would mean they’d be more likely to stay late for an overrun than cancel.
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What a brilliant idea. Should we have something similar for vascular surgery?
@VSGBI
@RouleauxClub
Calling all medical students & others interested in head and neck area
FREE BOOK will be available soon covering our specialty & related pathology!
Neck lumps, salivary gland, skin cancer, trauma, cleft, oral cancer & much more
Will post download link when we have it 😀
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Great for Tanzeem Raza who has a huge interest in and acumen for teaching. Amazing to see how he still loves doing on calls, with greater enthusiasm than some us, his younger colleagues. Reflected glory for
@UHD_NHS
We are pleased to announce that Dr Tanzeem Raza has been appointed as the International Medical Director for PACES. Dr Raza will succeed Dr Donald Farquhar. We wish Dr Raza well in his new role and extend our great thanks to Dr Farquhar for the great work he has done for PACES.
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A new space for Members and Fellows at the home of
@RCSnews
opened by
@DrFBE
and
@TMitchellFRCS
I'm bringing some surgical colleagues to visit the College and this will be an ideal place to relax and chat.
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3
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@DGlaucomflecken
Ivermectin for Prevention and Treatment of COVID-19 Infection: A Systematic Review, Meta-analysis, and Trial Sequential Analysis to Inform Clinical Guidelines, American Journal of Therapeutics July/August 2021 - Volume 28 - Issue 4 - p e434-e460
doi: 10.1097/MJT.0000000000001402
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Excellent by
@scarlettmcnally
We need more training posts to produce doctors to deal with the modern patient who has multiple comorbidities; to make high-order decisions that don't fit into protocols, order fewer tests, and have admin support too please!
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@9Nylon
I'm reminded how easy it was for a surgeon to make such changes in those days. Imagine trying to change the colour of the floor, walls and drapes nowadays: the hours of meetings and pages of procurement forms, the utter frustration, and then giving up.
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Matt you would be most welcome in our vascular unit - people of any persuasion or origin who love vascular surgery, work hard, have coffee after ward rounds, and get patients better. We did this before LGBTQ BLM and white privilege were coined. We can always do better
@UHD_NHS
I’m Matt an F2 with a passion with Vascular Surgery. As a gay man I have experienced a lot of discrimination in both my personal and professional life.
#PrideInSurgery
is opens this platform to support the LBGTQ+ from both a patient and professional perspective
#loveislove
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Pretty serious when you think they were supposed to receive a third of the usual dose. Imagine the fuss in hospital if a nurse gave a child 3 times the recommended dose of any drug.
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Some welcome balance on the issues of the NHS from a patient's perspective. This is also a first for me: cricket coaching from a grateful patient. If only I'd read it before I bowled yesterday.
@UHD_NHS
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1
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My colleague Miss Alexa Templeton organised a brilliant 'Learning through challenges' day for surgeons, nurses, podiatrists, vasc scientists from the regional vascular units. More local educational meetings.
@UHD_NHS
@oxford_vascular
@UnitVascular
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F1 phoned for surgical advice today and then I asked how her week had been: she's thinking of giving up. She wanted to be a surgeon, she's not sure now: lists lack of teaching, no prospect of life improving in F2/CT, no theatre time, no continuity of care, just firefighting.
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Just want to say what a great President
@Jonnyboyle1
has been
@vsgbi
. It was good to catch up with him and other surgeons
@RCSnews
from many specialties up and down the land. There are clearly many problems but a bit of bling always helps.
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These Israeli data don't explore subtleties such as proportion vx'd by age, but do show how useless vx passports would be at indicating who could or could not be ill.
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I have a gut feeling that most surgeons who deal with AAAs have recognised this for some time. Enforced delay of many elective AAAs during 2020, without resulting rupture, has simply confirmed my bias.
@vsgbi
@RouleauxClub
2
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Quite right. Most would agree that the quality of most mandatory training is poor and the quantity disheartening. The headline singles out doctors but other staff are also over 8yrs old and would gladly ditch most of it to do some real work instead.
#NHS
Mandatory Training under the spotlight. I've been arguing for over a decade that it's worse than a waste of time. We learn to cheat, we learn nothing useful, antagonises us against management, takes time away from doing patient care.
@somersetwyvern
@pamkato
@GavinLarner
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@mstotty88
I wouldn't be surprised if 80% becomes the (desired) usual pattern in most specialities. We just need more numbers to take up the remaining 20% training time.
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Well done all the graduates. We in the vascular unit
@UHD_NHS
are especially proud of
@vivekandan
who kept us on our toes and gave me plenty of clinical advice😆
Congratulations to the Vascular & Endovascular Surgery
#MastersofSurgery
Class of 2022 who graduated on Saturday 👏🎓🧑🎓🎓👏
@RCSEd
@uoe_online
@EdinUniMedicine
@VascEd
@PhillipaBurns2
@ProfW_edinsurg
@ProfG_Edinsurg
@PRCSEd
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A very special morning
@RCSnews
for Diplomates, their friends and families to hear
@DrHenryMarsh
speak about walking the tightrope of surgical practice. Not groupthink but group working. Be a good colleague yourself if you want to have good colleagues.
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2
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@calvinrobinson
I used to walk past the statue every school day for 7 years and knew exactly what her relevance was to the Empire. Locke's changes look ridiculous. At least the 'statue dressing' is only temporary. I won't be visiting again.
@BhamCityCouncil
0
1
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Trainees battling it out
@RCSnews
in the
#RCSSurgicalSkills
competition. Good luck to all and we'll done for getting through the heats
0
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Brilliant evening at the
@UHD_NHS
review Pandemoniium. It's been two yrs waiting for excessive toilet humour and bawdy sketches. All for charity of course.
0
2
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I often whine about NHS IT. Today I need to thank them profusely
@UHD_NHS
I somehow managed to delete the vascular rota for the next 2 yrs and couldn't restore it.
The IT man was fantastically patient and rescued me from certain death at the hands of my colleagues.
0
0
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3 cases of life-threatening bleeds from femoral vessels today: 1 post angioseal, 1 post endarterectomy and 1 ruptured false aneurysm from drug abuse. Great that our trainee was involved in fixing them. Worth knowing what to do and what not to do. Join the webinar.
@RouleauxClub
Sign up for the next ASPIRE Junior Webinar on Vascular Emergencies - How to Approach and What Do I Need To Do As A Junior
Thu 26th May, 8pm
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Heard thw good news that
@UHD_NHS
has got charitable funding to buy each of us 3 reusable theatre caps. This small start is our bid to reduce costs and waste and part of the Green Theatre Checklist
@RCSnews
#sustainability
Can't wait to choose mine
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1
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I'm so grateful to Eseenam Agbeko our vascular reg and ISTP trainee
@RCSnews
who happens to have a PhD in palliative care, for giving this talk about patients for whom no further intervention is possible. Thanks
@Debbiesharman
for the invitation.
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Excellent news and well deserved Carol. Not only is she eternally cheerful, but she knows how to get things done, knows her job inside out, and just gets on with it. If only more of us followed her example.
Wow what a great lady - Carol Skillen who has worked here for 18 years & today received an award at Royal Bournemouth hospital for demonstrating excellence in our values
@UHD_NHS
our ‘walking ray of sunshine’ - thank you Carol - discharge coordinator & bank therapy assistant
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FRCS Vasc exams in Dublin. My first time
@RCSI_Irl
. Brilliant organisation by Clark and Declan at JCIE.
Hard work but I always learn something.
Lovely to examine with my old boss
@profdjascott
, old Reg
@sir_ginger
and old research colleagues
@ChetterIan
@coughlin_pa
2
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15
When I was in surgical training I had little idea how important the expertise of my palliative care colleagues would be to patients with vascular problems. Ischaemia can be as incurable as some cancers. Here's to palliative care nurses and doctors.
Mel has an exciting new role. She is our ‘front door’ CNS working in ED, AMU and Short Stay, enabling earlier palliative care, as well as supporting our staff to give excellent end of life care
@RBNHSFT
@CNEamonn
@CEO_RoyalBerks
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Robert Liston supposedly could amputate a leg in 2 1/2 mins. I find myself examining FRCS Vasc under this portrait of the great man in Surgeons' Hall
@RCSEd
.
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Yesterday in my rush to get to an emergency in theatre I stupidly left my car engine running. Huge thanks to the nurses
@UHD_NHS
who tracked me down and didn't drive off in my car!
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Important work being done by
@RCSnews
to support surgeons who need to juggle responsibilities of parenthood and their training. Probably good for consultants too.
Today we launch our new
#ParentsinSurgery
report. Hear from our Vice President Fiona Myint about why this project is vital to cultivating a diverse and effective surgical workforce. Read the full report and join the conversation:
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Who needs endovenous therapy or compression bandaging when you can use Germolene?
@VSGBI
@RouleauxClub
@vascularnurses
@legulcers
@LegsMatter
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I love using Biogel gloves rather than the poorer alternative in my hospital, Protexis. No 7.5 available anywhere today so lucky we have a secret stash for just such moments. Don't tell will you?
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@gordonwgfrench
@LashmarVicki
The patient actually wanted her to do the operation rather than me
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