nhs doc

@OrthopodReg Could you do a post to help post surgical trainees about SIMG pathway? Do you think its identical for surgical subspecialties or varies aka general vs ortho vs ent? And the costs. Thanks.

People are messaging me about working in 🇦🇺 & 🇨🇦 vs 🇬🇧 My DMs are open. Happy to advise, talk pros & cons etc And there are defo cons. The grass ain’t entirely greener. But… …when it comes to salary: spot the difference For clarity $218,553 🇦🇺 = £111,195 🇬🇧 #medtwitter

@farkomd Axillary cut down for access; Sma covered stent after POBA&IVL prep; would also then try non covered celiac trunk stent since we are already there. if surgical candidate, for bypass. If endo, for experienced visceral artery specialists only

These are a few of my favorite things. #AortaEd. How would you manage? Attempts at #ENDO failed (#cardiology) referred for Chronic Mesenteric Ischemia. #coronary #CTA clean. Recovered smoker(10 years). Early 60s. On maximum medical therapy.

@DrLindaDykes Meanwhile UK f1s get random allocation&treated like shit.

I love the way that American Residency programmes celebrate their incoming teams.

@DrRajeshG1 Love the clinical exam wisdom. May i ask…with a detailed clinical hx, no examination or investigations…can one diagnose this?

Almost interruption of aorta distal to L subclavian with huge collaterals. Patient came with C/O palpitation, probably non arrhythmic. Lower limb pulses almost absent, systolic murmur at interscapular area and Suzman sign. Missed until the age of 20 yrs. Always palpate lower limb pulses during CVS exam and in all patients. Nothing substitute a detailed clinical exam, never forget that art of medicine. Better to touch the feet of patients in exam hall (as he/she is going to decide the result), the Indian way of getting blessing from elderly.

X-ray for residents and fellows. Look carefully

@hanansuhail99 @DrRajeshG1 When a prof of cardiology puts up an x-ray…its NEVER normal

@DrRajeshG1 maybe some incidental findings

@timricketts_ Base pay £100k minimum. Uncapped bonus based on performance - should be atleast hitting £200k.

To the public: A professional goes to university for 5 years to study for a masters level degree. Then, undergo 7-10 years of postgraduate training, completing complex exams and assessments. They perform operations, save lives and lead teams. How much should they be paid?

@karananandpara @SIRRFS @SIR_ECS @SIRspecialists @keithppereira @KprasMD @kmadass @vascularIR @LessneVIR @SriniTummala @t_intheleadcoat @_backtable @IVISymposium @Vascular_India @iRadRock @TheRealDoctorOs @monteromiguel @IRadPatwary @iRadBIR_Chennai Can see entry and exit site on Lt IVJ.Then coursing down posterior mediastinum. If in the oesophagus would expect some free gas. Puncture might have been through&through - then everything via wire, US guidance. If this was done with fluro guidance then I dont know what to say…

Case 13: Tunnelled Dialysis Cath insertion done elsewhere. Referred for no backflow. What next? . #irad #MedTwitter #MedEd @SIRRFS @SIR_ECS @SIRspecialists @keithppereira @KprasMD @kmadass @vascularIR @LessneVIR @SriniTummala @t_intheleadcoat

@timricketts_ By being determined.

To anyone who passed a postgraduate exam whilst working full time: I’m in awe of you If you have kids as well… how did you defy the laws of space and time?

@Vish_Sharm Reject. This contract is for the streets…

1/ Important update: After a month of intense negotiations, we have received an offer from Government to settle the current pay dispute. Although it doesn’t deliver everything we asked; the consultants committee felt there was enough progress to put it to our members to vote on.

@MStott88 ED do use CT to triage. I dont blame them…either its a normal 5mins CT to report or a 5mins abnormal one. If patient’s lucky a T1 tumour is incidenly found and investigated - this may lead to “over diagnosis/treatment” or genuine increase in “life expectancy/QoL”

@IR_warrior_ It’s absolute tribalism. I can’t think of another specialty that has to have a constant argument with ED about arranging appropriate investigations for a presenting problem. It’s like not doing an ECG and TnT in chest pain cos medics can do it if they want it.

Surgery should only accept CT proven pathology

@mmamas1973 Specilaists doctors need to form consortiums&offer services to the NHS/PP. This UK monopoly employer model dosent work.

Take a minute for this to sink in. Medicine attracts the brightest and most academically able students, and is probably the most challenging degree to complete. We value our doctors so little in the UK and break them down that they quit to become dog walkers for a better salary. There won't be an NHS in 10 years time as we understand it today.

@DrRajeshG1 @mmamas1973 Because the Govt wants to cut costs. It is government policy. The royal colleges adhere to government policy. So ultimately patient care is not priority. Bringing costs down is. And also controlling& managing PAs is easier than controlling doctors.

@mmamas1973 Why the politicians are doing this? I don’t understand! Why we hear these from the land of Prof Stanley Davidson?!! He wrote Principles and Practice of Medicine, the first word of the title is getting buried ?

I'm a Professor of Cardiology with 23 yrs clinical experience (11 as a consultant). I get invited all over the world to give lectures and teach and I'm involved in international guidelines for the treatment of cardiovascular diseases. I would be a danger to patients working in primary care as a GP equivalent despite this experience. Someone with only a two years Masters and no medical training has no role seeing acutely unwell patients in Primary Care.

Well thats why hes the CEO of a broke ass CQC “requires improvement” nhs trust and not a FTSE 100 company lmao @HullHospitals

@theveindoc The NHS just needs to collapse

So we need more administrators and managers before more doctors

@Xeon4f145d96s1 Because that would mean we prove how fucking useless PAs are lol

@DannyHartwell58 @SkyNews Nobody cares what you think danny boi. In the nhs soon Noctors will exclusively be treating you.

@SkyNews You knew what the pay and conditions where when you started and inflation is not at 35%

Dr Tal Ellenbogen of the BMA Junior Doctor's Committee says it is 'regrettable' strikes have taken place, but argues the proposed pay increase of £14 to £20 per hour would receive a 'resounding yes' by most, despite the govt rejecting it. trib.al/Rx0iR33 📺 Sky 501

@theveindoc Hopefully groups of specialty consultants can get together, form a group and provide their services as a private entity to local GP, NHS&PP hospital groups. I hope the UK goes to that model. Soon. Very soon.

Why do most dentists seem happy to work privately instead of directly for NHS but most doctors (on here at least) seem appalled by the idea? Are these attitudes already decided before applying to university?

@theveindoc Because dentists have freedom of choice. UK is a monopoly employer. There is no competitive private sector. You have to risk it all and create your own. Until then at the mercy of trainjng program for ARCP&CCT. A lot of GPs and “aesthetic” Drs do full private.

@clifford0584 Family, friends and support network. In any other country, you are just an IMG; Aus protects its own trainees and specialists (unlike UK) very well (aka getting into training; 10yr memorandum, needing residency etc). IMGs get the non training jobs local trainees dont want.

Why does anyone stay here in the U.K. or in training these days? What are the benefits?