Tim

Urgent care continues to expand across Victoria, with Urgent Care Paramedics starting to play a role in these settings. Over the last few weeks, I have been onboarding into one of these roles with the ForHealthGroup at the Carlton Clinic within Inner Melbourne. I have really enjoying getting stuck in alongside an awesome multi-disciplinary team of nurses and Doctors and taking care of patients in this setting. I’m looking forward to seeing how the role grows and how it continues to integrate into patients care needs to support the UPCC models! #UPCC

This article should be mandatory reading for every medical student, PhD candidate, researcher—and honestly, for anyone who mistakes expertise for certainty. “The importance of stupidity in scientific research” sounds provocative, almost offensive. But Martin Schwartz is not glorifying incompetence. He is describing the real operating system of discovery. Science is not built on knowing. Science is built on tolerating not knowing. That distinction matters. Most of education rewards correctness. School teaches us to answer. Exams reward speed, certainty, and precision. You feel intelligent when you get things right. Research is the opposite. Real research begins exactly where competence ends—at the frontier where nobody knows the answer, including the people you thought must know. That moment is psychologically brutal. You ask the expert. The expert shrugs. You assume you’re missing something. Then you realize: no—this is the work. You are not failing. You are standing at the actual boundary of knowledge. That feeling—“I must be stupid”—is often not a sign of inadequacy. It is often the first sign that you are finally asking an important question. Medicine struggles with this. We train doctors to avoid uncertainty, to fear being wrong, to perform confidence. But the best clinicians and the best scientists know how to sit inside ambiguity without collapsing into fake certainty. This is why AI in medicine also deserves caution. Systems trained only to reproduce established answers may become extraordinarily good at passing exams while being terrible at discovering what matters next. Guideline intelligence is not the same as scientific intelligence. Discovery requires productive stupidity: the willingness to stay with the uncomfortable, to look ignorant, to ask naïve questions, to be wrong repeatedly without protecting your ego. Most people want the authority of expertise. Very few want the humiliation required to earn it. But progress lives there. Not in certainty. Not in performance. Not in sounding smart. In the quiet discipline of saying: “I don’t know… yet.” And continuing anyway.

The Doctoral Award is now open for applications. This 3-year training award is designed to support the career development of all health and social care professionals through PhD research. Find out more on how to apply, and register for our webinar to learn more about the Award on our website: nihr.ac.uk/funding/doctor…

@AdamBoulton17 @joshkimbre @ResusJournal How does this compare to services that incorporate critical care paramedics not reliant solely on charity funding ?

New paper from my PhD fellowship now in @ResusJournal 🔗doi.org/10.1016/j.resu…🔗 One-line summary: 🚨 The inequality in access to prehospital critical care for cardiac arrest patients is driven by geography 🚨

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Burnout, Stress, and Moral Injury Among Emergency Medical Services Clinicians: A Systematic Review - Journal of Emergency Medicine jem-journal.com/article/S0736-…

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@jamie_wallis @ShivaniM_KC I just don’t know how you know this about paramedic training or the epidemiology of the paramedic caseload

@TimEdwards76 @ShivaniM_KC Paramedics are highly skilled in management of acute illness. HHS/DKA, yes. But a pt doesn’t call 999 to have their chronic diabetes managed! If the focus of paramedic training is skewed towards chronic diabetes mx then I would say there is a real problem with the training!

I’m going to say something that might get be cancelled. Type 2 diabetes isn’t managed by GPs. It’s managed by GPs, practice nurses, pharmacists and paramedics of varying abilities. You can have one PCN with a highly skilled GP who would rival a specialist given their experience and expertise in T2D who supports the allied HCPs. And at the other end, my patient was recently seen by the paramedic at the practice who started 6 months ago. Highly variable. No doubt excellent care in some places, but totally unsupported in others. Now, I’m not saying that any of these healthcare professionals can’t manage T2D - anyone can follow a protocol or guideline. But I am saying that the experience of managing T2D, the nuance and the medical knowledge underpinning T2D management no longer sits with GPs in many practices. Ofc the same reasons this has happened ARSS, GPs being replaced etc

@jamie_wallis @ShivaniM_KC I’m just interested how you know that about paramedic education and why they are less equipped than other practitioners with appropriate training to perform these roles

@TimEdwards76 @ShivaniM_KC A paramedic by their very nature practices acute medicine, not chronic disease. There are many things they could bring but I don’t think chronic diabetes management is one of them. I’m sure many wouldn’t want to either? (I’m not disrespecting paramedics but this situation)

@jamie_wallis @ShivaniM_KC Definite variation in models for employment of paramedics in primary care but why specifically is a paramedic Poundland medicine ?

@ShivaniM_KC I re-read your tweet and shocking about a paramedic with 6 months experience in primary care! I believe in a chronic disease model run by trained nurses and pharmacists with experience of chronic disease management, overseen by a GP.. but not Poundland medicine 😡

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Trainee Critical Care Paramedic recruitment open. It’s that time of year again, we are excited to invite applications for @SECAmbulance CCP. This year vacancies are in Kent. Details and apply here - apps.trac.jobs/job-advert/770…

The Faculty of Pre-Hospital Care offers a yearly student elective programme. This report was written by Zarah Butt about her facilitated elective with @Ldn_Ambulance. 🔗: fphc.rcsed.ac.uk/education-reso…

The Faculty of Pre-Hospital Care offers a yearly student elective programme. This report was written by Libby Jones, final-year medical student at the University of Nottingham, about her facilitated elective with @WelshAmbulance. 🔗: fphc.rcsed.ac.uk/education-reso…

A short seven years (!) after I started writing the code, it’s great to see this paper published. We use high-frequency NHS to data show that short-staffed, less experienced nursing teams deliver worse outcomes – with the largest mortality impacts for patients with sepsis.

Chemsex: core knowledge for emergency medical service responders from BPJ 9:3 by Peter Kingsley is now #OpenAccess. doi.org/10.29045/14784…

Vacancy: Clinical Trainer - RNLI Full info👉 collegeofparamedics.co.uk/COP/BecomeAPar…

I’m seeking interview participants for my PhD study about patient safety in non-conveyance. If you had an ambulance out for yourself or you were there as a carer (either paid or friend or family) I’d love to talk to you. Please see ad below for details. Please share!

@DrLKVaughan Hi Louella it is stroke video triage and not done by phone and has been subject to evaluation.

undifferentiated pts into pathways, increasing the risk of true strokes being missed and delays for pts with other serious conditions. It is also inefficient, putting yet another (expensive) clinician into the pathway. The workarounds are killing the system.

I found out yesterday that a new component has been added to the Stroke pathway. As hospitals with hyper-stroke services are receiving so many stroke mimics, LAS now has to ring a consultant after they have done their initial assessment. The consultant then decides where 1/

🚨 Student Paramedic Opportunity! The College of Paramedics & RCSEd are offering limited places for student members to support the Diploma in Immediate Care Exam. 📧 Interested? Send an expression of interest to carl.smith@collegeofparamedics.co.uk 📅 Apply by 30th Oct 2025