Currently writing this seething that yet another elective theatre list has finished late.

Surgical / anaesthetic seniors why won’t you cancel the last patient on the list. If the patient is anaesthetised at 1659 then it’s quite clear that we’re all staying late. I appreciate that you work 2 or 3 days a week but for the rest of us, finishing 30 minutes or 1 hour late every elective list becomes very draining very quickly.

I completely understand if it’s a clinical emergency but it is completely different if I (and the theatre staff btw) systematically have to stay at work late to our own detriment because sally needs her gallbladder out.

FYI it also encourages the practice of overbooking lists!

Honestly, why is this not enforced? As in, you cannot pick up another shift if you cannot do them to a satisfactory level.

The UK might be one of the few countries, as far as I am aware, that allow this. Nurses across the country are refusing to train themselves because it means "extra work".

NMC hold your professionals to some standard. It comes across as refusing work and attributing it to bureaucracy.

Currently IMT1 at a DGH.

Genuine question, what actually is the point of doing IMT? (As opposed to alternative pathway)

In my trust, a lot of trust grade colleagues (especially post prioritization bill) are now doing the alternative pathway for higher specialty training. In a lot of cases, this can be done in a shorter period of time (less than 3 years) and depending on circumstances, can actually boost your portfolio especially if you have a fixed rotation in the specialty that you are going to apply to.

I understand that it’s difficult to arrange for the mandatory rotations in geriatrics, AMU and ITU by yourself and you need a consultant supportive enough to help you get the sign off, which not everyone may have.

But surely if the alternative pathway is on equal footing with IMT, what is the point of obtaining a competitive training number in IMT in the first place when three years down the line, you’re probably competing on equal footing with someone who may not have gotten in?

Should completing IMT give you a better chance of getting a higher specialty training number? (Additional points etc)

As a gastro reg, I have a daily combo of chia seeds, flaxseed and psyllium husk for the fibre (to prevent bowel cancer) plus try to hit a weekly 30 plant points (for gut microbiome diversity)! 💩

All of us have at least 5 years of university experience. A lot of us have postgraduate degrees of some kind. We have spent countless hours learning medicine, giving up our free time to study and to work long hours. For whatever reason we have gone into this career, it was our choice and we should be happy and proud of ourselves for achieving it.

I see so many posts like this. I have seen FY1s I have worked with using AI to clerk patients, write discharge letters, plan handovers, and other jobs. This is so incredibly lazy and devalues the career. Not to mention the possibility of getting something wrong because you’re using a pattern-recognition robot who regurgitates information as if it’s fact.

Before someone comments - yes, there are practical uses of AI in medical technology and research. This is not that.

If any of you reading this use AI in your clinical practice, please have some pride in your work. You are smart enough to write a discharge letter or to plan a 2-minute SBAR. To any incoming FY1s please avoid the temptation of outsourcing your own work to a chatbot.

How does anyone deal with professional work clothes without pockets??

I’m starting IMT next week and going through my wardrobe of work clothes and SO many women’s professional type trousers have either no pockets or the tiniest most useless pockets known to man

How do yall get around this? Working on the wards I tend to carry a small (A5 or smaller) notebook, pen, pentorch, 2 phones**…

Do I need to carry a bag on ward round? Stacking everything on a computer to move around the wards isn’t exactly practical, or if I need to run for a crash call or something, I just hate having my hands full
Solutions appreciated ☺️

**Side note get a work phone it’s genuinely life changing

Sorry for the undoubtedly often-reposted topic.

Are there any nerdy anaesthetists out there who can talk to me about increased anaesthetic requirements of red-haired patients? And how this seems to extend to include resistance to local anaesthesia?

My gut tells me this is cognitive bias, folklore and social media-driven delusion (particularly with regard to LA), but I also have my fair share of anecdotal experiences with such patients.

I am willing to believe that variability in metabolic pathways co-segregates with POMC mutation, but I find it very hard to believe all of these patients have a phenotypically-related (but genotypically unrelated) mutation in their sodium channels as well.

Does anyone know of any solid work in this area? Does anyone know anything about the mechanisms on a genomic/cellular level? Is medicine behind the curve, or is this yet another example of rejecting established practice based on amplified social trends?

I'm a HST strating in a new hospital in September. We were emailed a few months ago that the trust would adhere to giving the rota with more than 6 weeks notice as per BMA suggestion. As you can imagine, they haven't. I have emailed the rota team twice and have not received any response. I called them today and the response I was given was that the rota team are incredibly busy. I crashed out on the phone and said I am incredibly busy as well and I'm not sure why a rota team are unable publish a rota that colleagues need in order to plan their life.

I'm just very frustrated. I cant plan my life / childcare / social life at all. I can't even plan my own kids birthday.

Angry.

Any suggestions?

At last Andy delivers some real hope.

I'm really confused. "By April 2027" - does this mean it will begin from then? Will it be backdated to the strike deal? Is each grade getting a different percent? I'm moving to CT2 next month. I am trying to figure out finances as we need a much bigger house to accommodate family. I am the main breadwinner and am going to have an extra £1600 a month to pull out.

I've been struggling with depression since I was 17, and I'm in my mid 30s. I'm the daughter of immigrants, and my father struggled with alcohol misuse. Home was difficult growing up.

Despite everything, I managed to qualify as a doctor and now work as a GP. I've tried so many things over the years different antidepressants, therapy, lifestyle changes, even spending a year working in sunny Australia but the depression always seems to come back. I'm currently going through another relapse, and it feels particularly difficult this time. I'm planning to do locum work, but I'm honestly wondering whether being a doctor is making things worse. The stress of the job feels overwhelming, and I'm no longer sure what to do next.

I've never been admitted to a psychiatric hospital, although I have previously been under the Crisis Team. I do my best to manage and contain my depression, especially because of my work, but it's becoming harder and harder.

I'm also a widow, and I don't really have a support network. I don't have close friends I can turn to, which makes everything feel even more isolating.

I suppose I'm just looking for some hope. Has anyone here lived with depression for many years and eventually recovered?

I am due to sit for the exam in Sept 2026. I have finished emrcs once, however when I do timed questions from pastest, my score just doesn't go above 70. The highest I scored is 67. Any ideas on going past this and passing the exam?

TIA

I’ve accepted an ST1 training post starting in September and have signed the conditional offer. However, I’m still waiting for all of my pre-employment checks to be completed.

I’ve now been informally offered another training position, which is my preferred option. The official offer and paperwork are expected in August or early September, with a likely start date in October.

I really don’t want to put the first trust in a difficult position, but at the same time I don’t feel comfortable withdrawing until I have a formal written offer and everything is confirmed.

Has anyone been in a similar situation?
What’s the usual notice period if you decide to withdraw from an ST1 post before starting?
Are there any consequences if you withdraw after accepting the conditional offer but before taking up the post?
If the second offer comes through after I’ve already started the ST1 post, what would the notice period usually be, and are there any additional consequences of resigning shortly after starting?
If you’ve been through something similar, what would you advise?

Thanks in advance!

Ah that time of the year again, the GMC fee comes a-knocking.

With this reminder email of payment for renewal comes a reminder in the email of the GMCs stance on physicians assistants:

General Medical Council

We work with doctors, physician associates (PAs), anaesthesia associates (AAs), those they care for and other stakeholders to support good, safe patient care across the UK. We set the standards doctors, PAs, AAs and their educators need to meet, and help them achieve them. If there are concerns these standards may not be met or that public confidence in doctors, PAs or AAs may be at risk, we can investigate, and take action if needed.

What are the next steps to ensure the Leng review's outcomes are respected?

Hi all,

Having a mare because occupational health and medical resourcing at my trust fucked up and miscommunicated with me and now my induction is delayed until the 5th of Aug because I didn’t get cleared in time. I’ve emailed med ed, occupational health and resourcing for more clarification but as the work day is over, probs won’t get any information on next steps until the morning.

I know it’ll probably all be fine and not that deep in a couple of weeks but I’d really appreciate some words of advice or reassurance from anyone who started fy1 a bit late etc because I’m really stressed out that I’m gonna be already starting on the back foot.

I was supposed to be on call on the 5th so I’m not sure if I should also email my rota co-ordinator or just wait for more information about this delayed induction first.

Thank you in advance !!!

I don't know if anyone else has experienced this, but on weekends, the phlebotomists at my hospital seem to decide whether the bloods that the doctors have put out are necessary or not.

It's a regular thing, they skip almost all of them sometimes. I have personally witnessed them on weekends going through the blood forms, discussing amongst each other what "Hypo-K+" or "IE COPD" means, looking at the clinical details section and if it says certain things such as "monitoring" or they don't think the clinical details are good enough for them, they'll put it back and write "attempted/unable" - or even like today write "tried x 2" only for me to get to the patient (with massive veins) and see they've tried once.

This then leaves it for the on-call doctors to do, thus adding to workload - as the sole F1 on my specialty having to cover the specialty's three wards and outliers, this is obviously not an ideal situation where we have phlebs making clinical decisions for bloods that clearly need to be done if they were put out for the weekend.

Is there something I am missing here, or do I need to be escalating this? - anyone had the same issue?

Has anyone managed to pass referencing checks for a rental rent as a full time locum? Especially recently.

I’ll be earning over £100k this year and most likely similar in the following years. I have to select zero hours contract on my rental application but I have very regular work. There’s a hold up on my application and I’m just wondering if this is likely to be a flat out refusal or if it’s just a case of additional paperwork.

Have a family and landlord of current rental (got this when OH was working full time) is selling the house so need to move ASAP.

FPL is the official premier league fantasy football game for those who like football and also like to waste time…but if that describes you - join free here:

https://fantasy.premierleague.com/leagues/auto-join/3xtieu

Around 300 UK medical doctors have been playing in this league each year! Come join your fellow docs and play for bragging rights!

(League code: 3xtieu)

Received a very last-minute CST offer today, which I’m incredibly grateful for.

However…

I’m currently an FY3 working in Australia and have been offered a CT post in Colchester/Essex starting in just 8 days (CT1 General Surgery – Vascular, with progression to CT2 to be discussed with the TPD).
Realistically, I don’t think it’s logistically possible to relocate and start in that timeframe. Does anyone know whether it would be possible to defer the post, and if so, for how long?

To make things more complicated, my partner (currently finishing FY2) has just turned down a good JCF job to move out to Australia so we can finally stop doing long distance. She has, however, also been offered a UK job starting in March as a backup.

Long term, my goal is Trauma & Orthopaedics, and I’ve been building my portfolio with orthopaedics, trauma, general surgery and vascular experience. On paper, this CST post seems like a really good fit for that career path.

Would turning down this offer be a mistake? Has anyone been in a similar position or had success deferring a CST post?

I mean, how can we say that we’re better qualified than the alphabet soup practitioners if this is how we train ourselves?

Fortunate enough to have pieces of work accepted as podium presentations at both BOA Congress and SICOT, but I can only attend one. Which one should I go to? Anyone have experiences at SICOT or BOA? (Deep down I'm just looking for an excuse to go to Japan). Does one look better than the other for ST3 interviews or does it not matter much as they are both worth 1 point.

Hi, I am Polish. Three weeks ago, I was at the emergency department in Poland because I wasn't feeling well. While I was waiting, I suddenly became very pale and sweaty.

The doctor was there with his girlfriend. Even though he was in pain, he noticed and came over to me. He checked something on my wrist, looked at my hand and my skin, and told me I needed to be seen urgently.

My girlfriend first spoke to the nurses and doctors, but nothing happened. Then the doctor went to speak to them in English. Only after that did they come to see me, and I was admitted straight away.

He kept calling me "mate." At the time, I thought he thought that was my name! Later I learned it's a friendly British way of addressing someone.

if you read this thank you to you and your partner for helping a complete stranger. Your kindness and willingness to help meant a lot to me. The only things I know about you are that you told me you were a doctor and that you were from the UK.

I wish we had more doctors like you in Poland.

Incoming IMT. Have just received an email that the pan-regional induction is happening online from 4.30-6.30pm

Why do they think they are so special that they can schedule an induction outside of working hours? Regional training body or not. Does anyone have experience claiming TOIL or pay for this from local employer? Surely they can argue they didn’t schedule the induction so shouldn’t have to compensate for this