Tom Lewis
@thomasllewis
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Trauma and Orthopaedic Surgery | Foot & ankle surgery | Surgical research | Education | Widening access | Sailing | Amateur 🚲 | Currently in 🇦🇺 #orthotwitter
Sydney, New South Wales
Joined October 2010
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Pinned Tweet
All doctors are involved in teaching - but what is the easiest way to collect & collate feedback for portfolio/appraisal? Here is a simple setup (takes about 5-10mins to setup) which sig automates the process and makes it really easy. A Thread:
#meded
#medtwitter
#orthotwitter
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89
As a surgeon I am deeply concerned by the GMC latest tweets and video. I don’t want my patients who I’ve seen in clinic and trust me implicitly to be put at undue risk due to AA’s acting at anything more than 1:1. The idea of 1:3/4 is frankly terrifying. 1/n
13
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934
My unpopular medical opinion: ward doctors (who are not on call) should not wear jeans or trainers (or worse both)
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573
Quite impressed by this list of acute abdomen differentials in London Underground style!
#medfinals
http://t.co/2Eqt40sQtF
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The GMC video has really changed the dynamic for me. I appreciate the landscape has changed since it was filmed but the fact that ways to “get around” the very rules designed to protect patients were not challenged does not sit well with me.
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How to make the most of core surgical training and get an ST3 post (or things I wish I was told at the start). A thread🧵:
#orthotwitter
#medtwitter
#surgtwitter
#meded
#notrainingtodaynosurgeonstomorrow
3
54
222
Very pleased to share that I passed both parts of the FRCS. It’s been hard work but I had great support from friends, family and colleagues. Onwards and upwards, to CCT and fellowships. Can’t wait to help mentor the trainees in our deanery to help them pass the quiz
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I’m also really concerned about the medicolegal aspects of all this. If an AA (who is unregulated) makes a mistake and I’m the most senior dr in the room - is that on me? Also what happens if I refuse to operate knowing I have an AA and therefore my patient is at increased risk?
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@WelshGasDoc
My consultant turned to me once in a case and asked if I fancied writing a case report on the patient as they were "99% sure it would turn out to be the first recorded case of iatrogenic vicryl poisoning based on the length I was cutting the sutures...."😂
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Incredibly proud to have completed T&O surgical training in SE Thames. Outcome 6 at ARCP today along with my colleagues; Sam and Thana. Very grateful to all my colleagues and trainers along the way who helped make this possible
19
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Local scope of practice clearly won’t work as employers who are under pressure will push the limits and ultimately it is patients who will pay the price. I do see a role for PAs and AAs but it is tightly controlled within a very defined (and therefore safe) scope of practice
1
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I wonder if they have included the standard NHS costa coffee in the Nightingale hospital? How will the teams manage without a post ward round coffee?
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Reflecting on recent oncalls. Teaching SHOs is one of the most rewarding parts of my job. The increase in their ability, confidence & enjoyment in their job after even simple teaching or practical procedures is great to see. Who knows, might even convert some of them to surgery!
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1
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@DrBenLovell
-Rota emailed with plenty of notice
-Leave requests acted on quickly
-Training culture across multiple consultants
-clinics well managed and not overbooked to allow time for training
-a locker
-IT logins arranged ahead of starting
- not put on call or nights on day 1
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2
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Seems renal have joined the hammer darks side. Not entirely sure why though…. 🔨 🔨 🔨
#orthotwitter
30
7
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So
#OrthoTwitter
. What are the ten golden rules of
#ortho
?
?The classics….
- Get on bone and stay on bone
- Thou shalt not varus
- If struggling, make the incision bigger
(In the spirit of the rules of anaesthesia tweet 👍)
@NickFerran
@Orthofacts
@OrthopodReg
@jamestoml1
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Fellowship confirmed for Sydney 🇦🇺 if that isn’t a motivating factor for
#operationFRCS
then I’m not sure what is
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Can't get over how useful this will be for managing on calls. Here is a template I made in
@Accurx
which could easily be sent to a patient with ambulatory trauma awaiting an op to confirming details about their op. This will massively improve dr-pt comms.
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These anatomy diagrams of the median, radial and ulnar nerves from
@TJQPNI
and
@OrthohubXYZ
are fantastic for FRCS revision
#orthotwitter
0
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Calling hip arthroplasty surgeons -> do you prep the foot before draping when doing hip arthroplasty?
This study from
#VEC2021
found contamination of sterile field when foot not prepped.
->given PJI is devastating, probably should always prep the foot
#orthotwitter
#EFORT2021
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Calling all knee surgeons - the London Knee Osteotomy Masterclass is now free to register. Very experienced international faculty and anyone interested in knees should consider joining. Register here->
#orthotwitter
2
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Have written to my MP regarding
#NHS
pensions crisis. I've seen the impact in my own department. 3/8 consultant surgeons reducing their hours & now refusing to do extra lists. The pension issue is directly affecting patient care
@MattHancock
@goldstone_tony
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Pleased to share I’ve been accepted as a member of the Faculty of Surgical Trainers of the Royal College of Surgeons of Edinburgh (
@RCSEd
@RCSEdFST
). Can’t wait to develop my skills training the surgeons of tomorrow.
#notrainingtodaynosurgeonstomorrow
#OrthoTwitter
#meded
9
4
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Yay finally got a rota for next job. Its only taken 12 emails and 4 phone calls and 3 weeks. Really is the little things that affect morale
9
21
62
Thank you very much to
@BritOrthopaedic
for kindly awarding me the top Travelling Fellowship award. Hugely looking forward to Sydney for fellowship to collaborate with 🇦🇺 colleagues to find solutions to issues affecting all of us & work out how best to implement these across 🇬🇧
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2
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Don't agree with the decision to use the MSRA for CST selection (esp with no notice). Moving the goalposts at the last minute is incredibly demoralising for hard working junior docs. We will lose good future surgeons because of this
0
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Very proud Trauma and Orthopaedic Surgery are leading the way celebrating new trainees joining our rotations in the NHS. Instilling a sense of community and pride in our training can only be a good thing for morale. Would love to see other specialties and rotations joining us
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I went on the Exeter Hip Course in November 2019. Yesterday, I received a reminder postcard containing my own learning points from that course! Very nice touch 👌
@ExeterHipUnit
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Preparing to start ST4 tomorrow in new dept. Things that would be nice to know in advance:
1) A copy of the on call rota
2) Is there departmental induction?
3) A copy of my day to day timetable
4) The consultants/subspecialty I'll be working for
*sigh
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Last elective list as a trainee today. Fab team, great cases and overall a fantastic day. Proud to have trained in SE Thames. One on call and trauma list to go till 🇦🇺🌏🦘
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I heard a new variant of the anaesthetist/surgeon operating time joke the other day. I asked for 2 doses of post op antibiotics. Half way through the case (Which admittedly was going slowly) the gasman piped up “do you want the first dose now????”
Take a bow my friend 👏👏👌
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2
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In F2 teaching. Group of 30 asked plans for next year. Only 4 taking training posts next year! The staffing crisis is REAL
#JuniorContract
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Last weekend on call as a registrar. People of south London please take extra care and delay any activities involving trampolines, monkey bars, ladders or high speed motorbikes till at least Monday. Thanks 😊
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As I reach the end of surgical training, I wanted to share 5 key books that have really helped improve my skill development, understanding, focus practice and the way I approached surgical training. I advise all my colleagues to read and see what insights they can get: 🧵 1/7
5
5
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When I’m a consultant I will make it a mission to ensure that new SHO’s aren’t forced into an on call weekend or day within their first few days in a new department. It’s unnecessarily stressful and avoidable with careful Rota planning
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1
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Really grateful to
@crooks_sophie
for nominating me for the Silver Suture award. Couldn't be more pleased to share the prize with
@ujwaliofficial
. Absolute top guy and awesome trainer.
#ASiT2021
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4
44
Attempts to learn
#neuroanatomy
greatly enhanced by this great article from
http://t.co/cwC5yYkfHm
via
@NeuroMBC
http://t.co/A69zAlKcHt
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Orthopaedic SHO’s following the trauma theatre reg when they hear there’s a DHS on the list
#orthotwitter
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One of those fantastic days in theatre-brilliant team, great boss, loads of learning and teaching. I know surgical training can be hard in the NHS at the moment but when it all comes together, it’s the best job in the world.
#orthotwitter
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ATLS complete and as a bonus nominated for instructor potential :-)
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So today a CST said they had the best day of their surgical career because I "let" them operate. I said "No, you demonstrated you knew the risks, benefits, steps and procedure inside out. My job is to help train you to be the best surgeon you can be"
#loveteaching
#lovefeedback
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Opens twitter this morning:
-Surgeons can’t sew🧐
-Parents trust app to diagnose tiny human 😱
-Profession getting ongoing abuse from patients with a derogatory hashtag 😨
Sod it. I’m going back to bed
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@surgicalsheel
@Mini_doc_Hannah
Surgical juniors need the stars to align to get theatre time these days. The fact this reg took the time to teach at 3 am (when could easily have done the case themselves) shows significant commitment to training and education. Well done that surgeon
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@JonJHilton
Fixed rotations for CT and SPR so you can plan your life. Training days once or twice a month rather than an hour a week). Dedicated half day admin every other week for portfolio/audit etc. Less emphasis on ridiculous portfolios. More input and change if specific jobs are bad
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Pleased to share I've been selected to join the
@BOSTAA_UK
trainee committee. Looking forward to getting involved
#orthotwitter
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This appears pretty harsh about medical students:
1) We *didn’t* have everything laid out
2) Teaching time was rarely ‘earmarked’
3) and it’s simply untrue that we were ‘hardly ever there’
We did all that the PA students did & more. The attitudes here are outdated & unnecessary
Great eloquent presentation by Clare Morris
@mgacsm
focusing on Physicians Associates
#MedEd
ASME small grant winner - really lovely insights into attitudes and experiences
@CG_MERC
@aomeecg
#asmeasm2018
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This welcome to the department is the basic kind of appreciation that would go such a long way in the NHS. My timeline is full of departments welcoming brand new doctors in and making them feel valued
Congratulations to the incoming 2019-2020 OHSU general surgery interns!
@OHSUsurgery
@OHSUNews
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One of those fantastic days in clinic and theatre where you get excellent teaching, exposure to a range of pathologies, personalised feedback and cases. It’s pretty doom and gloom at the moment, but when surgical training works, it’s the best thing ever.
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Very grateful for this opportunity. Looking forward to meeting new people as well as gaining valuable insights and approaches to foot and ankle surgery
Congrats to Tom Lewis for winning the ON
#clinicalfellowship
at Duke Orthopaedics Arringdon! He can look over the shoulder of
#orthoregeneration
expert Samuel Adams. The renowned foot and ankle surgeon offers unique insights into his work.
#education
#onfoundation
@DukeHealth
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ARCP OUTCOME 1 💪
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Over the moon as today at the age of 30 I finally got on the property ladder. It may only be a small ground floor flat but it’s my* ground floor flat. Over the moon doesn’t even begin to describe it 🏠 😍
*pretty much entirely the mortgage company’s flat but meh
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Great day in theatre. Motivated trainers who really focus on making you a better surgeon. Measurable increase in skills. Why can't every day be like this??
#notrainingtodaynosurgeonstomorrow
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The impact of COVID on surgical training is clear from these 2 graphs of ARCP outcomes and eLogbook case numbers Dec2018-May2021. Got to look after our surgical trainees at all levels!
#NoTrainingTodayNoSurgeonsTomorrow
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Many of you know I am passionate about surgical education and surgical training. I am running for the advisory board of the Faculty of Surgical Trainers (
@RCSEdFST
). Members should receive an email today with a link to vote.
I’m keen to share why you should vote for me (1/n)
3
5
22
Well done to everyone who got a T&O ST3 number today. Anyone joining SE London & want to find out a bit more about the region then please drop me a message. For those who weren't successful - hang in there, keep going & good luck for the future.
#orthotwitter
#medtwitter
1
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Branches of External Carotid Artery - Some Anatomists Like F-ing Over Poor Medical Students
#medfinals
http://t.co/hxIT4ZubTu
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It’s always very special to hear about how well the juniors you’ve worked with are excelling and doing well. Training is so important
#notrainingtodaynosurgeonstomorrow
0
1
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Did a virtual reality ACL reconstruction using an Oculus Rift today and OMG it was amazing. Can see how it would be a total game changer for trainees getting to grips with arthroscopy & develop 3D skills. Screenshot shows hip scope but gives an idea of what its like
0
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Congratulations to all who got ST3 T&O NTNs.👏👏
For those who didn't quite make it, hang in there, focus and come back stronger next year!
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Surgery has a bit of a bad rep for FY placements. Here are some tips for FY1s (of FY2s) rotating or starting surgical jobs that hopefully make things a bit easier 🪡🧵:
#medtwitter
#orthotwitter
#meded
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I hope you’ve found this thread useful. If you have please like and RT. If you have any questions about anything, let me know and I’ll do my best to answer them.
#orthotwitter
#medtwitter
#surgtwitter
#meded
#notrainingtodaynosurgeonstomorrow
1
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Pretty amazing evening in
#Skye
this evening. Nothing like a few days away to press the reset button 🏴
1
0
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Congrats to
@MrDanPerry
@TJQPNI
@jamestoml1
@sujithkonan
on getting highly prestigious
@BritOrthopaedic
ABC fellowships. Can’t wait to hear how you all get on
2
2
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Got home from on call to find this on my doorstep 🙂
#weareallortho
#isupportdiversityinorthopaedics
#OrthoTwitter
0
1
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@gourmetpenguin
I have a cork jar. Every special event that was celebrated with fizz is recorded on the cork. Eg here is the cork from the champagne when I became a dr
1
0
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Very pleased to be an
@NIHRresearch
Associate PI. Looking forward to developing my research skills
3
0
20
Been contacted about numerous stories of
#CST
trainees being docked points for no reasonable reason. Glad to hear there is national awareness about this
@OrthopodReg
etc. Happy to help wherever I can
0
3
19
.
@otorhinosaurus
@traumagasdoc
@pkakodkar001
@orthochimp
This is a great slide to explain surgical risk in pt terms
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11
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@drbstewart
I’m making a list of simple things I can implement when I’m a consultant to make junior staff feel more part of the team and I’m adding this to it. Thanks
1
0
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Great day in theatre with
@kneedoclond
. So many useful technical tips & learning points for knee examination and ACL surgery. Have spent the past hour writing down everything for future reference. So fortunate to have great trainers
#surgicaltraining
#orthotwitter
1
3
19
Rogue signs springing up in
#NHS
trusts as disgruntled staff show frustration
@Thejournalofmed
http://t.co/ybGeIb3JyW
http://t.co/1fKiCgmxmy
2
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19
Great resource for all
#medicalstudents
. Complete set of downloadable
#medfinals
notes-informative and useful
http://t.co/Su3a9v6M
#meded
0
15
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Congratulations to everyone who passed FRCS (Tr and Orth) Part 2. It's an excellent achievement and reflects all the hard work put in. For those who didn't quite make it this time, keep going, you'll get there next time.
0
2
19
Really lucky to have motivated consultants organising our regional deanery teaching covering FRCS syllabus. Friends in other deaneries have massive variability in quality and quantity of regional teaching. How can we improve things??
#meded
#notrainingtodaynosurgeonstomorrow
6
1
19
Outcome 1 for ARCP. Roll on ST8 and the last year of T&O training!
0
0
18
It has been a truly glorious trip to
@DukeOrtho
. Welcomed by everyone, complex cases, fascinating discussions.
Special thanks to Dr Sam Adams,
@Dr_deCesarNetto
,
@TheFootAnkleDoc
, Dr Mark Easley amongst many others. Thanks to
@on_found
for their invaluable support.
#orthopedics
1
0
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Just finished first day of
@ExeterHipUnit
Hip Arthroplasty course. Excellent faculty, support and venue. I’ve learned so much today and looking forward to tomorrow.
1
2
17
So proud of
@Munsterrugby
right now. Tough match but great to scrape the win. Amazing support as always
@MRSC16
@MRSCLondon
#SUAF
#GLAvMUN
0
1
16
Off to do my first list in a private hospital today with NHS patients. Will be interesting to see how it goes
#notrainingtodaynosurgeonstomorrow
#NoTrainingTodayNoSurgeonsTomorrow
There are *no* barriers to trainees working wherever NHS patients are cared for. Including the private sector
This time it’s a Core Trainee and some CTDs (and me)
@ASPHFT
@BMIHealthcare
@ASiTofficial
@bota_uk
@RCSnews
@RCSEdFST
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2
16
Of course, I have been rota'd to work nights for the week that I *specifically* requested annual leave for. *facepalm*
5
7
16
Really enjoyable first day on the
@BOFAS_UK
ankle arthroscopy course. Excellent faculty, great lab. Can’t wait for day two.
1
1
15
Devastated to hear close mate doing CST quitting medicine.Yet another rota gap&loss to
#NHS
. 6/27 of my FY1 cohort have now completely quit
9
40
16
Great weekend teaching ATLS as an IC. Lovely informative faculty with loads of teaching tips. Enthusiastic candidates. Made it through so now an ATLS Instructor☺️. Looking forward to teaching on future ATLS courses 👍 Thanks to
@PaulCDent
,
@TriScalpel
,
@MarkBagnallSurg
and others
1
1
15
One week until flying to 🇺🇸 to go on a short travelling fellowship to
@DukeOrtho
to learn as much about F&A surgery as possible. Very grateful to
@on_found
for supporting this
#orthopaedicsurgery
opportunity
#MedEd
3
0
14
Masters of the Air is one of the best shows I’ve seen in ages. Would highly recommend to everyone. Brings me right back to watching Band of Brothers and The Pacific
0
2
15
Had a great day at
@BOSTAA_UK
annual scientific meeting. Some really interesting talks, lots of great research and the opportunity to meet new/old friends and future colleagues. Great venue at Lords. I’m sure BOSTAA 2024 at Twickenham will be even bigger!
0
1
14
- Shelf stacking
- Barman
- Manual labour in cheese factory
- Sailing instructor
- BSc. Physics
- Grad Entry MBChB
- MRCS
#mypathtomedicine
0
4
14
One of the best parts of my job is introducing junior doctors and medical students into the world of orthopaedics and showing them why it is one of the most rewarding specialties in medicine. Will never get tired of teaching to those who wish to learn
#orthopaedics
#orthotwitter
1
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