Ahmed Shalabi ☀️
@shalabolic
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Doctor by day, batman by night. Cons Gastroenterologist. Passionate about quality & training in endoscopy. Always look after your juniors! @shalabi .bsky.social
Gotham City
Joined February 2011
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Right let's get to my thoughts on
#RCPEGM
now although I was told I may give myself an aneurysm..
First of all. Thank you to the fellows who made this EGM happen & allowing members to stream. I cannot express how grateful I am (and I'm sure many many others are too) 1/n
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How did
@JAG_Endoscopy
approve a pathway for an unregulated profession to practice endoscopy. It's bonkers. Who is responsible for the complications? There is so much wrong with this..
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Finally, it was clear to me the majority of the audience weren't buying what the leadership were selling. Therefore the only way forward is either the leadership resign or there is a vote of no confidence. How can you lead without the support of your members? End/
#RCPEGM
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Fuck it.. I'm gona stand for election to the BSG council... Probably 4 people will vote for me and I barely meet the essential criteria but one has to try and make a stand..
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A moment where my jaw dropped was during one of the presentations an officer stated global issues as the barrier to training & not necessarily PAs. No!! A surgical junior stuck on the ward while the PA is in theatre is not "global".. 5/n
#RCPEGM
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@djnicholl
was so eloquent and detailed in his presentation. Honestly put everyone else who presented to shame. There was evidence behind every point he made. He made a point that by 2037 PAs graduating will far outnumber doctors graduating? 4/n
#RCPEGM
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The "takeaways" from the survey were presented in an embarrassing way. They lumped in "positive" & "neutral" as one vs "negative"... Even a dumbass like me was calling bullshit on that.. The survey should've been presented as raw data but we know why they didn't! 3/n
#RCPEGM
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What stood out was the audience on all sides of the debate making more sense than the officers (honestly I was disappointed). A big thanks to
@djnicholl
@parthaskar
@AcutemedNatalie
@DrAnimeshSingh
@DrAsifQasim
& others on their valuable contributions. 15/n
#RCPEGM
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My first thought was "oh the officers really can't read the room here at all".. It was embarrassing how they could not answer this simple question "when PAs eventually can prescribe & order iodinising radiation, what is the difference between a PA & a junior doctor".. 2/n
#RCPEGM
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The officers kept tripping on themselves trying to justify "scope is determined locally" when everyone in the room knew this was pretty much "kamikaze medicine". Again admitting the obvious meant there would've been some resignations.. 11/n
#RCPEGM
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There was this line that was parroted on repeat: valued member of MDT, we must supervise all members of MDT. Noone could answer this: what discipline does the PA bring that noone else can? 8/n answer below..
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Because they would then have to reckon with the fact PAs role has changed & scope creep has occurred under their watch. PAs were supposed to do the tasks that freed up the doctor to deliver the patient care needed and ensure they got the training needed to progress. 9/n
#RCPEGM
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The leadership were against motion 5 which is slow down rollout and get this fucking shitshow sorted before patients are harmed left and right.. In any other situation they would agree but again if they did there would be financial implications 13/n
#RCPEGM
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How they could say "financial implications" as if it meant anything when patient safety is the real & imminent worry is beyond me. Again PAs in roles that have clearly defined scope supporting doctors can work.. Not the clusterfuck of stories we hear about every day. 14/n
#RCPEGM
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Rheumatologist asked "what do they bring to the MDT that I don't already have".. Answer? Bit of fluff.. Because the truth was "doctor-lite" but noone will admit that so just keep the facade going... 12/n
#RCPEGM
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The common theme throughout was the views of the leadership of
@RCPhysicians
not reflecting the views of the membership or even fellowship for that matter. So who's views were they reflecting then? Well... 6/n
#RCPEGM
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What eventually happened due to a lack fo scope is PAs taking training opportunities meant for junior doctors & becoming senior decision makers when this was clearly not what the majority of doctors expected. This brings me to scope.. 10/n
#RCPEGM
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The views from the audience that were in line with leadership came from a representative from NHS England and a representative speaking for PCN. In addition there was a readout of a clarification from NHS employers. Now i know who's views were being represented! 7/n
#RCPEGM
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I am not a fellow.. Not sure I would ever either be nominated or accepted. I would however encourage all fellows to vote. Doesn't matter if you vote for or against motion 5.. JUST VOTE! 16/n
#RCPEGM
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Its devastating for PAs to watch this play out in public like this!
You have been let down by your consultants (major blame)!
You have been let down by RCP who have blindly gone down this dangerous path with no plan!
You have been let down by FPA who never cared about scope!
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Phil Smith
@PhilSmithIsBack
is truly selfless. He did his duty and then slipped away, quietly disabling his account. His contribution will never be forgotten. It will be written.
Hero
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So I have had 24 hours to digest what happened yesterday at
#RCPEGM
:
Honestly, the presentation of the survey results was one of most embarrassing things I have ever seen in my career as a doctor. I'm angrier about it now than I was yesterday. They thought we were mugs..
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the
#talkisjericho
podcast with
@RusevBUL
&
@LanaWWE
was both hilarious & insightful.
@IAmJericho
allowed them to shine & tell their stories
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BMA guidance is not for PAs. They are not BMA members hence can sayw "not following that".. It is for their supervising consultants to follow & so they are protected. Otherwise if something goes wrong, the BMA guidance will be waved at them "if you only listened"
@medicalmodelbri
@RCPhysicians
@TheBMA
This is a huge issue
Have already seen a PA post on here that they don't agree with
@TheBMA
guidance so they won't be following it
The arrogance of PAs is astounding
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So the BSG elections are now live. I am standing for election to council & in the endoscopy section. If you are a BSG member then please consider voting for me!
Please also consider voting for Rebecca Brown as the trainee rep to the endoscopy section!
One must walk if one talks
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This is really scary. Really really scary. Is this where we are going? An erosion of standards in this haphazard fashion?
Whilst
@BritSocGastro
&
@JAG_Endoscopy
are keen on Physician Associates doing endoscopy, I am receiving DMs such as this which really makes me worry for patient safety.
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1 thing for certain. I support
@johannmalawana
&
@TheBMA
in whatever JDC decides on Saturday. Our strength is in our unity as a profession
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Hamdulillah my dad is back home safe after 75 days of captivity..
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I believe
@PhilSmithIsBack
has done the NHS and the next generation of doctors the biggest service possible...
You think you failed my friend.. You absolutely did not.. You have succeeded! I and many others are grateful!
Ps. Please don't leave...
I had nothing to gain from speaking out about
#PAs
because of my personal situation, but could not live with myself if I did not. What I saw was wrong for patients, doctors and the NHS - an institution that has kept me alive. I wrote to the
@RCPhysicians
AGAIN in Sept 2023 1/x
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@juniordrblog
@WelshGasDoc
Hello doctor can you come and review a patient they had a nightmare...
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If you are a trainee member of any of the specialist societies or on the trainee committees.. Now is your time: speak up. Do not allow people to shut you down and move you along. I believe there is momentum. You must salvage your training...
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Ok so just finished my 1st shift on one of our COVID wards & wanted to reflect on my experience..
1. Its hard to to stay clean, you literally have to wash/gel your hands 6 times per patient. My hands are dry & cracked & alcohol gel stings like hell 1/n
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Im going to start calling my on-call team a militia..
#militantdoctor
@RoshanaMN
@DrSundeepGrewal
@johannmalawana
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I tip my hat to you sir..!
An Israeli, demonstrating outside the home of Benjamin Netanyahu.
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@timfarron
I think you were an honest and fantastic party leader. The mud slinging you got in 2017 was frankly ridiculous imo.
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These are essential: 1. Wrestling with shadows 2. Beyond the matt 3. Rise & fall of ecw 4. Cm punk: best in the world 5. Last of McGuinness
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#NXTTakeOver
card may be one of the best top to bottom cards i have ever watched but
@mauroranallo
's call of the main event was insane. My favourite match call ever! I salute you..
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They want to destroy UK undergrad medical education to a point that doctors from the UK are no longer desirable in other countries
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Guess I'm attending my first ever BSG AGM... Hard questions must be asked
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@drkeithsiau
I think the medical director calling you in for a post like that was actually not appropriate.
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Every trainee WhatsApp group in the country should be mobilising right now getting views and readying responses to send to their regional reps.
Silent no more..
Please retweet and share this..
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@DancingTheMind
@michaelgove
The fact that a "tweet apology" can somehow wash the stench away shows the contempt some politicians have for such serious issues
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You will struggle to find a better hour of endoscopy related education anywhere. Thank you
@NorikoSuzuki3
@MarkSdoc1
@yojit1
@HajiAmyn
&
@drahmirahmad
for the pearls of wisdom with fantastic work by
@sunmiha1
&
@sta_io
with the Q&A section
#Endocation
Complications of colonoscopy being discussed by
@drahmirahmad
at
@StMarksHospital
#ENDOcation
with
@NorikoSuzuki3
@MarkSdoc1
@shalabolic
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Say what? This is a cohort of patients that is quite unwell & surprising that King's liver unit would allow this... Surprising but no longer shocking..
King’s College Hospital in south London is the biggest tertiary liver transplant centre in the country – and its rota shows a PA working in place of an SHO doctor.
A staff member familiar with the service said: “The PA is definitely counted towards the minimum staffing of two
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Noone has damaged the PA project more than the officers of the
#RCPEGM
@RCPhysicians
. What "could" have been seen as naive can only now be seen as deliberate & malicious. They have swayed anyone on the fence but to the opposite way than they intended.
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The flimsy surgical mask and apron have me isolating in my bedroom with COVID-19... The swab came back positive! The government essentially condemned NHS staff to herd immunity.. Unacceptable!!!
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🤣 🤣 "why is all this happening during the Labour conference" 🤣🤣
📞"Liz Truss voted Remain in the Referendum and now under her the country's gone to pot. She is an inside job Remainer plot😡."
Colin from Portsmouth argues that nothing else can explain the Prime Minister's actions.
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Ajay you are a huge credit to medicine, gastroenterology and training.. I only wish some of our gastroenterolist colleagues (2 officers) felt the same way...
I wanted to make 2 points at the
#RCPEGM
(sadly ran out of time) to consider for those voting.
My declarations: I work at a DGH that does not employ PAs,
I am a
@RCPhysicians
elected councillor, chair of the colorectal section
@BritSocGastro
& a member of
@TheBMA
🧵 1/
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@UKGastroDr
@NHSEngland
@NavinaEvans
@NHSEnglandNMD
I cannot believe the stories that are coming out on a daily basis. Where on earth is the accountability..
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Feel so relieved this morning... Was afraid i would wake up with a cough but happy to report that is not the case and I'm still in the fight..! 💪
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@UKGastroDr
I think noone wants to tackle it as many figures will be embarrassed by their past actions or show themselves for who they really are. Case in point the RCP today..
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Just came across this thread.. It is very very harsh.. Yet when you break it down to mere facts and take any bias out, you can't really argue.
It's been the wild west for so long..
Listen, I have to get this s**t off my chest. Who the f**k actually believes it is acceptable to allow a so-called "health profession" to have access to patients, to do whatever the f**k they want, yet have no regulations or guidelines(so the public is not protected),
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This was not posted by accident today of all days. This is what "doubling down" looks like..
Regulation is changing. Legislation passed by the UK parliament means that we’re legally required to start regulating physician associates (PAs) and anaesthesia associates (AAs) from the end of this year.
Regulation will assure patients, colleagues and employers that PAs and AAs
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How can a journalist talking about figures and complexities of pay get away with writing subjective twaddle such as "fallen slightly".. How do you quantify "slightly".. Gives the impression pay isn't too bad when it is utter trash for junior doctors with high uni debt burden
👋
@BBCNews
This “news” piece by
@NickTriggle
on
@BMA_JuniorDocs
strikes is one of the most unbalanced one-sided pieces of govmnt propaganda I’ve seen in a while.
So much for “impartiality”
#TimDavie
- littered with errors and bias
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Today's
@RCPhysicians
#RCPEGM
was eye opening in many ways and I think has created a new generation of activists within the college.. To quote Jon Moxley - it was a paradigm shift..
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@RoshanaMN
@parthaskar
@doctor_oxford
I can't stress enough how far things such as appreciation & little rota flexibility will go to improving morale. The rigidity is frustrating
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@DrBenLovell
@mancunianmedic
This only works when the medical team have enough staff to see the patient quickly, otherwise it's a recipe for potential disaster
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Another brilliant thread by the guy who cared before caring was considered cool..
Since this email went out my phone & DMs have gone mad.
The leadership of the
@BritSocGastro
are good people but the timing of this email & some of its content has caused huge anger - the themes across all of them are: 1/x
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As my dad spends a second night in captivity by unknown assailants i continue to pray for his safe return. Gets tougher by the day.
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An Israeli airstrike kills on a playground in the middle of the day kills children as young as 10 on the spot.
Minimal headlines. Zero condemnation.
Wrong skin colour...
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Final thought of the night: when it is all said and done, I think we will look back and say this generation of junior doctors (with some senior support) saved medicine in the UK.. I tip my imaginary hat to you all!
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I don't know how she does it! Doctor, mother, activist, hunt fighter, writer!!! I can barely pull one off. Gr8 read!
My blog on Hunt's imposition U-turn: the one he's cleverly used parliamentary privilege to deny. # via
@HuffPostUK
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It wasn't libyan planes. U can take that to the bank. U think if we had proper planes then ansar sharia wudve existed til now?
#libya
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Who created those disingenuous slides for Friday? We need to know!!
I think the deputy registrar who resigned over the weekend did so after seeing the raw data and realising he was party to an absolute clusterfuck..
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Noone has crunched the numbers over the past few years for consultants quite like
@goldstone_tony
.. However you wish to vote, i would advise reading what he has to say!
I have voted YES*† in
@BMA_Consultants
pay referendum 👇
But my yes comes with footnotes, so
@PayReviewBodies
better be paying attention
Entire profession will be 👀DDRB & whichever gvmnt VERY closely in the upcoming report for 24/25 (around May-June '24)
RT
#PayRestoration
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Completed my COVID ward shifts for now & time for 4 days rest before I'm back at hospital for another 4 long days.. A few musings if you may:
I've been away from my family for a few days & I really miss them.. 1/n
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Hhhhhhhhhhhhhhh is used by arabs too lazy to switch the keyboard and type هههههههههههه
I love that people laugh in their own languages. Like jajajajaja in Spanish. Also seen hhhhhhh and hihihihihi (French?)
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@parthaskar
@docib
Did I miss the memo where we as clinical staff became enrolled in nursery? 😂
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@BeardedGenius
I think your hair transplant was the final straw. Made Fellaini say "fuck it im outta here"
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Some would have you believe this is perfectly within scope of practice.
Spoiler: it isn't..
This is dangerous and whoever is enabling this is causing harm..
🚨Another day, another dangerous PA
This time coming to you from Aberdeen
I’m told there is a PA, wife of a prominent consultant, who has been placed on a CONSULTANT Respiratory rota
Begging for someone to tell me this is a misunderstanding
Comments
@NHSGrampian
?
☠️ ☠️ ☠️
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Then that consultant can just do it.. Would've taken a shorter time than to actually find you..
@ollieburtonmed
The thing is, consultant supervising them came to me and asked me to prescribe for them, saying that they know what they're doing and I should just do it
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Hello
@Jeremy_Hunt
are u tucked into bed nicely? Meanwhile alot of us are doing something useful
#ImInWorkJeremy
http://t.co/pA0M963tz2
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This is an excellent statement.
@andymveitch
you said you wanted to hear from trainees and they have spoken loud and clear.
BSG trainee committee response to Physician Associates in Endoscopy
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@parthaskar
@DrNeilStone
I can guarantee you.. The ONLY reason anything on this issue is happening is twitter so yes Neil I would be very worried..
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I remain in utter shock that the
@RCPhysicians
leadership could handle the
#RCPEGM
this badly. How can physicians this distinguished and experienced make such errors of judgement. Anyone could tell "get ahead of this before it snowballs & release the survey in full"
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Wishing everyone at the protest all the best. Our resolve is strong. Our goal is clear.
#letsdothis
@RoshanaMN
@johannmalawana
@burnikov
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I thought I was out of ways to be shocked following
#RCPEGM
but I am shocked at this.. I thought the data was distorted but to this extent???
BREAKING
The senior officers of the Royal College of Physicians commissioned a survey of MRCPs’ views on physician associates (PAs). They have today released the actual findings, but the back story is shocking. I’ll link to the raw data at the end of this 🧵.
1/
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The experts reminiscing on why they chose their careers
#frontiers2021
@Dr_AlRubaiy
@SiwanTG
@AM_colorectal
@Bjorn_Rembacken
, Carolynne Vaizey, Grace Chan,
@VickyCuthill
@claire_taylor22
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Anyone who has either followed me here or knows me personally knows that my passion is junior doctors being trained properly & getting the opportunities I wish I had earlier on... This doesn't change as a consultant.. With.. Every... Ounce.. Of.. Energy.. I.. Have..
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I thought I was done with nights..
but nights aren't done with me quite yet!
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I would once again say shame on you
@Jeremy_Hunt
for this blatant
#smearthedocs
campaign but i suspect that it would fall on deaf ears
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Fantastic IBD talk on challenging cases the value of the MDT at
#frontiers2021
@RCPhysicians
@StMarksHospital
@BowelsOfStMarks
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There is so much nuance in performing these procedures, even with LumenEye. I mean we miss stuff with our rigorous training. I can't see how PAs won't..
Proctoscopy performed by PAs to rule out bowel cancer in patients with rectal bleeding.
I have questions! Patient safety, pathways, candour, funding, CoIs, supervision, missed pathology etc
Interested to see comments from Gastro & surgical colleagues.
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More informed than
@WWE
?
@solomonster
Nicki Minaj pulls out of concert in Saudi Arabia "after better educating myself on the issues"
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If you like please take a moment to support a fabulous mentor & human being who is fundraising for
@BowelsOfStMarks
On sabbatical I want to make a difference & challenge myself. What better way than go for a 790km 'walk' over 40 days in beautiful Spanish countryside? I'm fundraising for
@BowelsOfStMarks
. Check out my
@JustGiving
page and please donate if you can.
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Should you trust the radiologist? Read the latest GI snapshot quiz. Very interesting case we were involved with..
@sunmiha1
@drmanmeetm
@SiwanTG
@donalshee
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A recent example of this is Turkey & erdogan
And finally:
7. Wait for an opportune crisis for an ultimate power grab
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