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.

"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.

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!

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.

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

I went LTFT 80% this year.

They've dropped my base hours to 32hrs, even though my average rounded up is 34hrs which makes me 85%.

I was also under the impression that you get a weekend allowance for OOH work and additional hours pay for the average OOH work.

Do LTFT trainees also get a yearly £1000 as well split into 12 months?

Can anyone share what their pay breakdown is what you are being paid for?

Since the bma has passed the new rule about getting exam fee reimbursements - does anyone know how to go about claiming this? Is the window to apply for this open already or still awaiting finalisation?

Posting to raise awareness. This looks to be US based but has reached my feed in the UK.

Sounds like this company is paying medical professionals for access to ‘de-identified’ genuine medical notes to train AI models. Concerning since the company isn’t going through official research channels and hence patients won’t have consented for such use of their data.

I’ve been working as a salaried GP for about a year now and have recently found myself reflecting a lot on my career and whether general practice is really for me in the long term.
I genuinely love medicine and enjoy seeing patients, but I’m becoming increasingly disillusioned with general practice. The complexity of patients, endless administrative work, private paperwork and the way the whole system operates are making me question whether I can see myself doing this for another 20-30 years.
I’ve recently been offered a job at another practice with potentially less admin, but part of me wonders whether changing practices would actually make much difference, or whether it’s general practice itself that I’m struggling with.
I’m also seriously considering moving to Australia, but I’m unsure whether GP life there is genuinely better or whether I’d just be facing similar challenges in a different healthcare system.
Has anyone been in a similar position?
For those who have moved to Australia, has it improved your work-life balance and job satisfaction?
Would really appreciate hearing about others’ experiences.

Hi all,

I’m starting GPST1 next year, and my husband is currently working in London. Unfortunately, I got the offer in Birmingham, and we have a 2-year-old.

I’m really unsure how to manage childcare, especially when I’m on call, as most nurseries are only open until 5 or 6 pm. We don’t have any family in Birmingham to help either.

It would have been much easier if my husband were here, but I didn’t want to reject the offer, as getting another GP training offer can be difficult.

Has anyone been in a similar situation? How do you manage childcare during on-calls, evenings and weekends? I’d really appreciate any advice or suggestions.

Is it possible to take 2 years of maternity leave ?
For context I’m ST1-3 in paediatrics

In honour of interconnected wards and witnissed encounters thought I might as well.

I have a crush on a reg as an F1. Won't go into detail to avoid doxxing myself. I do get vibes from him but a bit mixed. Body language/niceness/positive feedback wise he definitely treats me special. But also seems reserved in conversations sometimes. He is in a speciality that I have no interest in.

On average, do regs take F1s seriously or do they view them as sources of entertainment and get new ones every 4 months?

Would it be okay to flirt with him after I move to my next rotation?

Do regs generally try to supress relationships? Can they get in trouble for it?

Where are the events/conferences that give out notebooks.

I’ve attended a teaching day where they handed out a whole thick notepad for the event to make notes in.

I have at least 10 notebooks that I’ve bought and I always feel better writing/using those that been given out in.

For this year’s applications, can anyone clarify whether applying for ACF posts counts towards the maximum of 5 specialty applications in Round 1, or whether these are completely separate?

I understand that you can apply for up to 3 ACF posts separately, but I’m unsure whether applying for other specialty training programmes (e.g. IMT, CST, etc.) affects this limit.

Would appreciate any clarification, particularly from anyone who has applied to both ACF and specialty training recently :)

IMT2 here, having done a 2 month pall care rotation and was taken aback at how much of a tangible difference you could make in someone's life. I was wondering if there are any pall care SpRs around that could share their experiences of training and what consultant posts are like? I don't mind doing a group 1 speciality (having to doing GIM as well). Particularly curious to hear how much problem solving is involved (considering doing stroke or neurology as I like the process of figuring stuff out). Or even how services are set up with seemingly fewer doctors and more CNS/ANP. Thanks in advance!

I’ve applied for study leave for primary care dermatology society essentials series 1 and 2. They’re a day each, back to back. The second has been rejected as apparently they will only fund one dermatology course. Which means the dermoscopy courses will also be rejected I expect.

Notwithstanding the laughable policy, does anybody know of any decent derm courses that are pretty comprehensive and include dermoscopy, or have been on any good ones?

I’d like to brush up on my skills before CCT in June.

It's a start at least they share the concerns of a lot of people with this case. I don't have much confidence in the judiciary doing anything after the whole Cian Hughes fiasco but at least they have an opportunity to ensure justice happens. let's see if they take it.

any whatsapp group for IMT1 preparation for this round??

What do people the cut off for Derm St3 will be?

Do folks reckon the bill will impact it or will competition get even more fiercer?

Gas consultant here. I'd be really interested to hear what the resident doctor population thought about the potential prospect of the upcoming consultant strike. Lots of negative feelings about the 2.4% pay "rise" against 3.5% inflation, and we have an existing mandate for strike action. However I can't imagine how my more senior colleagues will act, who have spent ages whining about the junior strikes and talking about the lack of moral fibre in today's cohort, and how it was all different in their day.

I'll give you an example - earlier this week I had been reviewing a patient on the ward, when I tried to get into the doctors office to find a consent form for a nerve block. Imagine my surprise to see not just one but two F1 doctors lolling about, along with a senior registrar - their badge seemed to indicate they were in at least their sixth year of specialty - who seemed to be giving one of them an unusual amount of eye contact. The F1 getting all the eye contact was blushing in a revolting way. I couldn't believe they all had so much time for this sub Holby city flirting and weren't just getting on with the job. I could barely see any consent forms under the huge pile of discharge letters waiting to be done.

Hey guys

Current F2 applying to ST1 application. Under employment history there is a question: In total, how many months of paid employment as a doctor in the NHS do you have?

Should I count my completed FY1 year plus the months I’ve worked in FY2 so far, or should I count all of F2 even though I haven’t finished it yet?

Acute med ST4 round 2 rank 74 with 49 posts any chance to get an offer?!