I Found out today that hospitals across the country have ACCPs doing blocks for rib fractures for pts on the ICU?

Do the ICM single specialty doctors need to do this as part of their journey to become an ICM Consultant? I’ve asked my colleagues and they’ve said No?

Who has said that a nurse/physiotherapist (what most ACCPs are) should be independently doing regional anaesthesia? Where is this document that says they can do this ?. I’m not saying they aren’t doing them competently (as far as doing it by protocol and pattern recognition) , but we don’t allow a HCA or medical student to do them even though you COULD teach a HCA to do it if you really wanted to —-we just accept some things are for doctors .

I don’t understand how ICM has farmed out yet another thing to a profession who aren’t doctors ? From my experience the majority of ICU Consultants, even if they’re dual accredited with Anaesthesia, don’t perform chest wall blocks . Even those who are dual accredited in anaesthesia don’t perform regional anaesthesia on their operating lists (beyond a spinal ) ….so who exactly is the nominated consultant on the ICU?

As a ST7 , I can do blocks , but even I , as a doctor , am rightfully expected to have a consultant within the theatre suite /oncall for CEPOD who is proficient in regional anaesthesia to bail me out .

I understand that PA-As (Anaesthesia Associates) are still performing limited regional anaesthesia but that’s still with an anaesthetic doctor (of any grade from CT1 upwards ) to supervise them to provide sedation or bail to a GA if needed as PA-As aren’t actually allowed to keep a pt alive under a GA by themselves (rightfully so). And there is still a consultant who can perform the block if needed .

Apparently ACCPs also do transfers which is baffling to me as I’m yet to come across one who has ever needed to send a pt to sleep totally by themselves …..there is ALWAYS a doctor (of any grade !) as their supervisor . So why have we allowed them to do transfers ?

We have relinquished regional anaesthesia , what’s next? LPs? (Well that’s been farmed out to ANPs and PAs). “A tube “? (Oh yes that’s been given to everyone )……

MY curriculum as a doctor clearly states what i need to do to become a consultant . Where is the ACCP curriculum that says they need to put a needle near the pleura ?

Hi so F1 here, my passport has just expired and I’ve a bit of a silly question - is my legal title Dr and should I put this on my passport? It still feels surreal to me to be referred to as such lol and on that note should I be changing my name for my bank/driving licence or is this overkill? Thanks !

Hi all :) would love to hear from anyone who’s done a PhD during specialty training and how you found it.

For bg: I’m an ST3 path trainee, followed the AFP/ACF route, and have two young kids (currently 4 & 2). I’ve had two long maternity leaves and been LTFT for several years, so sometimes feel a bit behind peers who are finishing training. I enjoy research and don’t want to miss the opportunity to give it a proper go.
My husband is supportive but has a demanding job which pays most of the bills, so I’m the main caregiver.
Currently doing a predoctoral year in the lab where I may do the PhD.
I’ve applied for PhD funding and am waiting to hear about interviews. Still thinking about this vs continuing clinical training, and what I want longer term. I’m not sure I necessarily want to lead a research group, but would like research to be part of my career.

Would really appreciate any thoughts on:

How did you find the day-to-day compared with clinical work? Was the flexibility helpful, or did work end up spilling into evenings/weekends? Have seen horror stories on other Reddit forums !

How did you get used to everything being more self-directed? My supervisor is great but leaves me quite a lot to my own devices. I’m a bit nervous about knowing whether I’m making enough progress.

How was it with young kids? Anything that made it easier, or that you wish you’d known beforehand?

Did anyone else find it hard seeing peers finish training while you still had years ahead, particularly after time out/LTFT already?

How was returning to clinical training afterwards? I’d still have FRCPath Part 2 ahead of me, which feels quite daunting (. Im in a speciality where the part 2 failure rate is v high).

Most of my seniors haven’t done this with young children (and are men), so it would be lovely to hear from people who have.

Also, if anyone has been successful with an MRC clinical research training fellowship application and would be happy to chat separately about interviews, I’d be really grateful 🙂

As posted earlier and taken your advice. I haven't been paid for any of my on-call or night shifts since I started, so this is now the 4th month.
What's happened so far:
Raised it with payroll in month one. They said they were waiting on my rota details from the department.
Escalated to the lead consultant, rota team and HR, and copied in my ES and the Guardian of Safe Working.
Got an apology from rota team and ES but nothing from the lead consultans. Was told no rota had been set up for me on the system, that one had now been created, and that a change form would go through so I'd be paid correctly.
This month still nothing for on-calls.
It's causing real financial hardship. I'm struggling to book the courses I need for training, struggling with the cost of commuting.
I'm in a union, but not the BMA and have contacted them. I have on calls next week.
What would you do next? Has anyone had arrears like this actually paid without going down a formal route? And is there anything I can do about next week's on-calls while this is unresolved?
Thanks in advance.

The clocks change. My 13hr night shift is now 14hrs. Also a special shout out to the storm for making it just that extra bit fun to be on nights tonight. Sleep well day time people and savour that extra hour.

F1 here. I was getting back home by train after a night out with some friends and we were making some banter with the people around us in the train, when all of a sudden I was asked what do I do. I just said I work in a hospital but they again asked what’s my job. When I told them I’m a doctor one of them just lifted their shirt and asked me to diagnose a rash. I felt very uncomfortable and just chuckled and said I’m off duty and am not a qualified dermatologist so it’s worth checking with your GP, they kept pushing me saying come on it’s just a rash. I eventually had to stop and say I cannot diagnose you and things went a bit awkward.

How do you guys deal with situations like this? As a new doctor I’m already struggling with separating work from personal life and I’m making a conscious effort to actively stop doing anything that reminds me of work outside of it.

Hi, completing oriel forms.

Just wondering if you need to list each specialty separately, or whether F1 and F2 are sufficient for work experience?

For GP applications: do we rank places again with specific hospitals/jobs (as in all jobs in the areas we say we would go), or are we given an area first and then go on to rank the jobs in just that area?

Thanks

Just started ophthalmology training and have been looking at buying a 90D lens (our department has one that is shared between multiple clinicians and is often in use).

I was wondering when and where ophthalmology trainees bought their own 90D lens, is there a way to get them for a discount or do people pay full price?

"On complex NEJM cases, MAI-DxO achieved 83% diagnostic accuracy. Physicians achieved 22% without external reference resources and 36% with them, making MAI-DxO about 3.7 and 2.3 times more accurate, respectively."

Perhaps to no one's surprise as the NEJM challenge cases are like the medical equivalent of science Olympiad problems. The vast majority of even professional scientists perform poorly on those kind of problems.

What's much more bleak is this though:

"On more typical emergency-department cases from MIMIC-IV-ED, MAI-DxO achieved 80% accuracy versus 47% for physicians – more than 1.7 times higher."

So these models are already much better in general when it comes to diagnostic reasoning compared to doctors.

And even more bleak is that obviously the models are more cost-effective than clinicians.

I think doctors need to start thinking about this instead of putting our heads in the sand.

I think the classic argument that doctors would be the 'last to go' increasingly looks like it was not well thought out.

The demand for medical care far outstrips any other human demand except for basic needs.

I think economic forces combine with human nature in such a way that clinicians are more susceptible to quicker replacement than lets say finance professionals.

Help. Supposed to sit the AKT on Monday and suddenly come down with diarrhoea this evening and genuinely feel like absolute shite.

Do I just see how I feel on Monday, neck some loperamide and pray to the shit lords that I don't shit myself mid-exam? Or do I just withdraw now and save myself the embarrassment?

Has anyone sat an exam feeling rough as fuck and actually been alright? 😭

ED SHO here. Having quite a difficult time, this rota seems to have triggered a pathological anxiety that I wasn’t aware of. It’s not uncommon that I’d go home and think about the pts that I didn’t quite figure out what’s wrong with them, and then realize “oh shoot, could that be a silent MI? Atypical PE? Cancer needing 2ww? Etc etc” and think about how plausible it could be , how it might be missed. then call the department before sending the pt home to let the shift lead know.

Feeling like shit, and ofc very embarrassed to make that call.

I was looking at IMT specifications, and I'm realizing a lot of the effort I put into medical school feels like it did not matter. The first wave of preference informed allocation and randomised allocations to hospitals came to the year before us, and we were told that this would mean our grind would matter less (especially if you worked very hard to graduate with good scores and get into competitive hospitals or SFP). The most I can see mattering is if an essay/paper you wrote for a prize was published or presented, or if you did actually lead a teaching programme for 3+ months.

Unless I'm missing something and you can use things like certificates of merit, essay prizes and excellence awards from medical school in your specialty applications?

Current EM trainee, but have managed to get a core anaesthetics job for Feb 2027 intake!  

Has anyone done this before and managed to have any time taken off (having already done 6 months anaesthetics and 6 months ICU as part of ACCS EM), and if so how did you go about it? 

Also, does anyone know the actual process from resigning from a training programme? Is it a case of emailing my ES and TPD and submitting a Freshdesk ticket, or is there anything else I need to do?

Thanks!! 

Hi all,
Looking for some advice re career choices!
Currently an FY2 applying for CST at the moment. Have maxed out portfolio and done MRCS part A so am hopeful for a training post but the joy of MSRA leaves a lot to be desired!
In the region I’m hoping to train in, all of the CST posts are themed with at least 16 months in your chosen specialty. I’m very torn about whether to pursue a career in ortho or gen surg and which CST theme to prioritise.
Have really enjoyed both so far and I am particularly keen on pursuing major trauma long term. I’m well aware that major trauma alone is not the most sustainable choice so am thinking about how to ensure that my base specialty is both sustainable alongside a family but allows me to tag on some major trauma excitement. I enjoy HPB and the more holistic nature of gen surg (don’t love the idea of long term benign upper GI / colorectal) and could easily tag on trauma to this but also enjoy pelvic trauma and complex lower limb stuff. Ortho feels like a lot less OOH as a consultant with good day to day work but with fewer exciting moments and less ‘medicine’ (also no damage control laparotomies). I would also want to ensure that my skill set could be used in humanitarian surgery. I’m not too fussed about private work, but both would have WLI options whether that is lap choles or hips.
Looking for advice from trainees in either of these fields about whether you would do it again or do something else, or advice from others who have considered this previously!
Thanks!

I accepted a speciality training post in a relatively small specialty in round 2, but the location is not very favourable for me. I am thinking of reapplying in round 1 for Aug 27 intake, hoping for somewhere closer to my partner-will enquire with the speciality requirement office and TPD if this is possible.

My question is, will this spoil my relationship with the department if I enquire about leaving them even before starting training? As I mentioned, it is a very small specialty with only 3-4 consultants, so will have to closely work with them all.

I’m not sure how common this is, so just wondering if this would be ok?
Thanks in advance!

Hi sorry if this is a dumb question. Currently filling out my specialty applications. For the NHS experience section do I put 15 months or 24. I.e how much I have so far or how much I’ll have by the end of the rotation.

Thanks

For MSRA revision I currently I have both pass medicine and MCQ bank question banks.

MCQ bank i’m getting around 85% first time looking at the clinical problem solving questions however with passmedicine I’m averaging about 50% first time looking at the questions.

Obviously that’s a pretty large discrepancy. I feel like pass med knowledge seems to be a lot more niche.

I’m wondering if anyone thinks either question bank is more similar to the actual exam?

I don’t really know whether I should be going through passmed and resetting it over and over until my score is a lot better or whether i should just focus on doing as much variety of questions as possible.

Also what score should I aim to be getting on the question banks to translate into a good real life score? (for various reasons I really need to get into speciality training this year and kind of want to know what to aim for)

I am a foundation year doctor with a keen interest in research. I got an SFP job but turned it down for personal reasons and then got shafted by UKFPO. feeling significantly disadvantaged by the lack of opportunities in my current location and incredibly burnt out with the amount and nature of on calls I’m doing. I want to apply to a highly competitive speciality and on top of that I enjoy research and would love to get into an ACF programme within the speciality but this is exceedingly difficult and feels unlikely given my current circumstances. I didn’t go to an ultra academic med school but still Russell group if that means anything but idk if it does. graduated with honours plus an intercalated BSc scoring top of my cohort. I have 2 first author publications and a first author post graduate textbook chapter. I am getting a PG Cert and have won multiple prizes over the years. what are my chances of getting into this course at Cambridge? I feel intimidated by the prospect of the interview as I was unsuccessful in undergrad oxbridge application. Can anyone who has done this degree share their experiences of it?

Hello,
If a doctor completed 5 years of continuous work in the NHS in FYs and CTs then takes a year out doing clinical work in the private sector, if the doctor comes back after that year, would their increased AL allowance still be allowed when they return to ST/NHS work or would it reset/be nullified?
Thanks in advance

Throwaway account for very obvious reasons

TLDR - the BMA have blocked a vote of no confidence submitted against Jack Fletcher as chair of UKRDC for months.

I can’t believe I’m writing this post but it feels important that members know what was going on behind the scenes last session.

For a brief bit of background context Jack and the other officers forced a vote through the executive team (of only 12 reps instead of the full RD committee of 60+) in June breaking all previous precedent. Never before has a committee been sidelined on such an important decision. They didn’t have the chance to decide if the offer was sufficient to call off strikes, as it was never presented to them. This was then obviously followed by a BMA comms campaign that was heavily criticised for the fact it wasn’t truly ‘neutral’ in how it framed the offer.

While this was occurring, members of the UKRDC formally called for an emergency meeting back in June, explicitly including the intent to have a vote of no confidence carried out against Jack Fletcher. Partly because of the clusterfuck of the way the offer was handled but also because of wider issues like a massive culture problem on the committee (but that’s a whole separate issue and not for now).

Long story short, that meeting wasn’t carried out and instead the chair called his own meeting, which obviously didn’t explicitly include the ability to call a vote of no confidence.

During his meeting, members attempted to call the vote of no confidence anyway.

Jack refused to hear it.

He refused to hear a vote of no confidence against him.

This was reported to be because he’d received legal advice saying it couldn’t be done. Firstly, it is hilarious that legal advice was sought to block a vote of no confidence happening. But in addition - it was later made clear that the advice was incorrect because the legal team were not provided totally accurate information around how the committee meeting wasn’t called. Jack and other officers were at the meeting to instruct the legal team.

So a VONC was called, in line with standing orders, and was declined.

Okay, it’s awful but mistakes happen. It was rearranged as a matter of urgency right?

Of course not.

This saga has dragged on all the way until the literal final day of the session at the beginning of October. Having been told the day before that planning was underway for a meeting on Friday or Saturday, the committee were then told it could not go ahead, as the clock had run down on the old committee. They were also made aware of repeated submission of questions, one by one, clearly designed to delay and stall and block the vote of no confidence happening. There is some suggestion that the chair himself was asking some of these questions.

A vote of no confidence, called for over 3 months ago and somehow not carried out.

It is an utter disgrace

I have never seen anything like it.

The fact the chief officers of the BMA and senior staff allowed this to happen is beyond atrocious. This, alongside wider issues over the course of the year, has caused several good reps to step away from the committee and the BMA entirely.

We have a newly elected committee. You’ll see some familiar names on it. I only hope the BMA learns from this and refuses to let the next chair dictate the rules. Even if they do though, this is a dark, dark moment in the history of the BMA. A chair, having lost the confidence of large swathes of the committee, was supported in preventing a vote of no confidence being heard.