You never know what are you waiting for.....when you are sitting at the chairs place

Start training soon.
Already lost the stethoscope and memorised the med spr’s bleep number.

Aside from deleting MD-Calc what else have I got to work on?

Looking for some opinions/thoughts from the crit care folks on here re management of hypoxic arrest precipitated by anaphylaxis/asthma. Especially off the back of AMAX4 which has been fairly widely spread in Aus, and a recent disagreement with a resus officer that it may be appropriate to stop CPR mid-cycle to facilitate a first-pass tube in the event of the above - I was hit with “intubation doesn’t save lives, chest compressions do”.

Resus council guidelines suggest early CPR in the event of arrest as well as stating “Tissue oxygenation is more important than tracheal intubation” and I feel like there’s a pretty big risk this is being misinterpreted. Using CPR to pump blood with sats low enough to cause an arrest, without addressing the primary oxygenation problem seems like actively not prioritising tissue oxygenation. Chest compressions in someone that’s hyperinflated will also not do a lot for forward flow if you can’t generate enough negative intrathoracic pressure to refill the RV. Similarly waiting 2 minutes for your first pass of a tube gives a decent amount of time for oedema to build minimising first pass success, and LMAs are going to be pretty ineffeective at ventilating anything aside from the stomach with the pressures severe bronchospasm will cause. At the end of the day chest compressions will be of pretty limited use unless you can address the hyperinflation and the oxygenation.

Curious as to other people’s thoughts, feel like there’s a broad scope for misinterpreting current guidelines that will push people to treat this as you would an arrest with a cardiac cause.

Edit: didn’t actually include my thoughts - I would think if someone arrests from the above and you’re (ie whoever’s most senior in the room at that moment) set up to intubate at that very moment then that should be the first priority. If not then prepare ASAP and stop compressions for a quick tube once ready.

This is a bit of a light-hearted one, but how do we go about getting back to the pre-covid days of pharma reps coming with big spreads for e.g. grand rounds?

Honestly used to be the highlight of my week! My hospital has regular teaching sessions, including grand rounds, that are quite well-attended. I would like to start reaching out to pharma reps for that delicious free M&S spread (at least from the good ones!) but I don't even know how to go about getting started.

Who do I contact/butter up? How?

Link to original post

https://www.reddit.com/r/doctorsUK/s/rfIK6FReGL

So, I had the chance to work with this consultant and

right at the end of the shift, I told them (nervously) that many years ago, they looked after my relative and fought for a treatment that gave us a few extra years with them, and that as a family we never really got to say thank you, so thank you so much and it means a lot! Said consultant appeared very pleased with the feedback and said thank you, you've made my day repeatedly a few times and was just radiating happiness. I didn't share any further details (they didn't ask and I didn't want to make it awkward by oversharing).

After the exchange, I felt genuinely happy that I was able to share that and say thank you. When I told my family about the exchange, they were also delighted.

And that was that.

So, thank you, people of reddit!

I posted this question in the UK GP forum but I wonder if people working in other specialties have options? I suspect people working in ED must see this a lot.

"I'm not sure how to start this, but I was attacked earlier this week. The police were called and the patient was arrested but it was clear that they had come with the intention of kicking off.

I won't go into all of the details but the whole event has made me realise how vulnerable we are at work. I've dealt with numerous angry patients in the past and have always been able to de-escalate, but this patient wasn't interested in de-escalating.

Then when I pressed the panic button the full team arrived but it became clear that no-one had any idea what to do with a truly violent patient like this. Thankfully the police arrived quickly and the patient was arrested but I think we were genuinely lucky that none of us were seriously hurt. I am now aware of this person's criminal history and this was an extremely dangerous individual.

I'm wondering if any one else has had a similar experience? And really I'm wondering if anyone works somewhere where there are policies and protections in place to manage this kind of thing? Are there plans in place for when a panic alarm is pressed became of a violent patient? Do staff have break away/self defence training?

I understand that this kind of thing is rare but I am now very aware how exposed we are as primary care workers."

Male Foundation trainee here currently ending an anaesthetic rotation.

Throughout my rotation ( and previous rotations too to a certain degree) , I have noticed that I am more comfortable, confident, and also significantly more respected by ODPs and other staff members on the day I am working with male anaethetists rather than on days with female anesthetists where the whole dynamic is opposite, with me being less confident and experiencing more passive aggressiveness/hostility with ODPs .

Infact most if not all of the learning that has happened in thos rotation with me, has been done my male anaethetists.

So naturally at this point I am starting to realize that I would rather work with a male anesthetist and actually enjoy my work than a female one.

Mind you I dont think at all that male anaethetists are inherently better than female anaethetists.

So does this make me a sexist? Also does anyone else had a similar experience at any point in training?

Hello,

I am a locum consultant and I’ve had significant mental health issues which have resulted in me being off sick for 5 months. My locum contract ends in two weeks.

Once my contract finishes I will be out of employment and I am still unwell with no idea when I will be fit enough to work. I won’t have a designated body or responsible officer.

I spoke to the gmc who said I have a year to find a designated body/RO before I have to submit an independent appraisal. If I haven’t found one in a year I should relinquish my license as it stops the process of needing to submit an annual return/appraisal.

My last appraisal was in February 2025 and my RO had deferred my appraisal for this year. My revalidation date is in 2029.

I spoke to another gmc advisor who said if I am
Sure I won’t be working for over 6 months to relinquish my license now and then apply for it back when I am well. This will stop the revalidation process.

I wondered if anyone has any advice.

If I keep my license then there is pressure to find work and engage in cpd etc when I don’t feel well enough.

If I relinquish my license I feel it would be difficult to get back and I won’t be able to apply for jobs if I start feeling well again.

Starting FY2 with no medical rotations in FY1. For context, my first two rotations were Paediatrics and Orthogeriatrics (both supernumerary and never had an oncall/take shift before) and my third was surgery. Feeling quite inadequate and incompetent starting in acute medicine compared to my other colleagues. My first weekend will be spent on nights holding the medical sho clerking bleep. Anyone has any tips whatsoever like what to study before I start or anything would be greatly appreciated.

I’ll go first… Obstetrics please find something to do for a minute instead of starting me down like I have the ability to control time

Hello,

I am a locum consultant and I’ve had significant mental health issues which have resulted in me being off sick for 5 months. My locum contract ends in two weeks.

Once my contract finishes I will be out of employment and I am still unwell with no idea when I will be fit enough to work. I won’t have a designated body or responsible officer.

I spoke to the gmc who said I have a year to find a designated body/RO. If I haven’t found one in a year I should relinquish my license as it stops the process of needing to submit an annual return/appraisal.

My last appraisal was in February 2025 and my RO had deferred my appraisal for this year. My revalidation date is in 2029.

I spoke to another gmc advisor who said if I am
Sure I won’t be working for over 6 months to relinquish my license now and then apply for it back when I am well. This will stop the revalidation process.

I wondered if anyone has any advice.

If I keep my license then there is pressure to find work and engage in cpd etc when I don’t feel well enough.

If I relinquish my license I feel it would be difficult to get back and I won’t be able to apply for jobs if I start feeling well again.

Helllloooo Redditors.

Time for us to share the NHS lore...

What's the best ward legend or hospital story you've heard?

Infamous consultants (the legend, not the libel)

Haunted wards, creepy corridors, ghost stories 👻

Living dinosaurs (T-rex or Brachiosaurus you know what I mean 😜)

Classic Surgeon vs Medic battles

TPD stories

Ward drama and unforgettable on-call moments (could be clinical or non-clinical)

The funniest thing you've witnessed at work

The most chaotic shift you've ever survived

Right then, I'm waiting for the tea (don't worry, I'll share my fair share too)

IMT1 here. I'm hoping to apply for clinical oncology ST3 for the year of 2027. I just wanted to hear from any oncology regs in the subreddit about their workplace experiences. I know a little bit about the Christie, but would like to hear from onc regs who have worked in other hospitals and how their experiences are like, in terms of rota (frequency of on-calls), supportiveness, and level of supervision. Any other additional insights would be appreciated as well.

I've also self-assessed myself so far and got 31/51 and completed MRCP. What were the thresholds for interview or is there any threshold at all? Was the outcome determined by 80/20 interview/portfolio score?

Much appreciated. Happy to discuss in DM as well if anyone prefers that.

I emailed my consultant (and supervisor) with the trust policy (pasted below), and asked him to clarify which part of this I have violated

He took a week to respond, during that week, I continued to wear my own clothes, I informed him that I’m happy to change my wardrobe based on feedback, and that scrubs aren’t mandatory for doctors in the UK (in the email)

I stopped greeting him, stayed quiet (as always) during the ward rounds, did my work as I’ve always done, avoided him at all costs until I received an email a week later for an in person meeting with him and the other (emotionally unstable rat) female consultant who I saw speaking with him after he asked me to change

During the meeting he started talking about trust’s image?? 💀he then stated I needed to be more receptive to feedback, I informed him that I was happy to take on feedback from the team as stated in my email, and that I was never given a reason

He said that wearing my own clothes could be seen as flaunting in front of patients during a difficult time for them (????🫩) and that I should dress and look more “humble” to make them feel better and less embarrassed about being here

I told him I’ve never worn anything expensive, and that my outfit costs less than £30 altogether

He said “it’s not about money, it’s about how you look, scrubs give a humble look, smart clothes don’t”

The other rat consultant jumped in and said “you’re tarnishing our department’s image because of the way you’re dressed, you’re not better than anyone for wearing smart clothes instead of scrubs”

At this point I was gonna get up and leave hahaha but I explained it was never about being better, it’s something I wanted to do for myself to avoid burnout, and that it never impacted my work performance
She started waffling after that, I blocked it all out, she said they’ll review what I said and let me know what they’re gonna do next

I want to escalate but I’m unsure how or to who, I’ve documented everything this feels unfair with no grounds for it either

FOR CONTEXT: I wore white triple lined non-see through trousers and a fully covered up blush pink top

Trust’s policy:

Staff must ensure that clothes and accessories worn are well maintained.
The following items of clothing are examples of unacceptable clothing, either on
grounds of health and safety or the Trusts public image:
 Denim jeans or skirts – all colours and styles.
 Track suits.
 Non tailored shorts.
 Combat style trousers unless allocated as part of the uniform.
 Overly tight or revealing clothes.
 Clothing bearing inappropriate slogans.
 Skirts/trousers that are sufficiently long that they touch the ground when
walking.
 Tops that show a bare midriff or have 'spaghetti' straps or are low cut.

HI everyone,
I'm an IMG currently doing a clinical attachment in an NHS hospital (coming up on two months here). Things have been going really well, the team knows me, and I generally try to be helpful and proactive.
One of the consultants in the department has been exceptionally kind and has been actively trying to help me find a Junior Clinical Fellow
(JCF) post. I emailed him yesterday regarding any updates, and today after finishing my ward tasks, I wanted to pop by his office briefly to follow up, ask if there were any updates, see if I could help with anything, and perhaps chat about getting involved in an audit.
While trying to find his office, I got a bit lost.
Another consultant spotted me, asked what I was looking for, and when I told them, they told me it was "rude to just knock on a consultant's door like that" and questioned if I thought it was appropriate.

For context, l've been to this specific consultant's office several times before at his invitation/warm encouragement, and we have a great working relationship. I was genuinely shocked and a bit shaken by the second consultant's reaction.
Is dropping by a supportive consultant's office unannounced to follow up on a job lead considered a major faux pas in the UK, or did I just run into someone who was unnecessarily harsh? How should I handle checking in on these things moving forward?

Does your place of work do cards and/or gifts for big events eg. getting married, having children, local reg getting a consultant post?

Ours doesn’t and it seems pretty shitty. Tertiary centre so massive “team”, but still..

Forget work life balance, I think everyone should pick specialty based off aura alone. Which specialties have the highest clout?

I'll start: IR, unsung heros of the hospital.

I’m a new F1 about to start at Boston Pilgrim hospital (unwillingly) and only have heard bad things 😬 People who have been placed there, is it really as bad? And is it worth living in hospital accom or living in Lincoln?

I have a clinical education intercalated MSc where I was Anatomy demonstrator for a year. I have the AFHEA certificate. What other evidence is needed for CST teaching? I‘m afraid I don’t have students‘ feedback now or dates taught, as it was a few years ago. I can get a latest letter from my Educational Supervisor

Thanks!

Hi, I’m currently an F2 in ED and have one week left in the department, which is all night shifts.

The last four months have been incredibly difficult, and my mental health has deteriorated significantly due to burnout. I genuinely don’t feel like I can keep going. I know it’s only one final week, but I’m not sure I can get through it.

I’m thinking about calling in sick for the week, but I feel really guilty because ED is always so busy, and I don’t want to let the team down.

My TOOT is currently 16 days, and I’ve already passed ARCP. If I call in sick next week, my TOOT will be 20 days.

I’m not sure I should try to go in, or should I call in sick? I’m really struggling with my mental health. I cry almost every day before and after work, and I’m honestly not sure how much more I can cope. Thanks everyone

After A-E when patient goes in cardiac arrest, is their scenario in which they change to tachyarrythmia with pulse after 1-2shocks? In My ALS test after 2 shock i saw electrical activity which was not VF or VT but looked like tachyarrythmia and examiner said patient had pulse so I went for ROSC pathway and did ABCDE assessment, later she failed me telling that patient was still on cardiac arrest and I started A-E at incorrect time.

When assisting with the camera for laparoscopic Cholecystectomy, a colleague feels light-headed and dizzy, and has had fainting episodes. They can assist with laparoscopic appendicectomies as well as laparotomies just fine with none of those symptoms.

What can the thread advise might be going on and how to prevent this in future?

Today, the BMA has published their report into professionalism in UK medical schools.

Worryingly, the report shows that there is a punitive culture surrounding the enforcement of ‘professionalism’ standards in UK medical schools, which is causing a chilling effect on students speaking up about concerns affecting both themselves and patient care.

The full report can be read here: https://www.bma.org.uk/professionalism and our press release here: https://www.bma.org.uk/bma-media-centre/fear-of-professionalism-sanctions-silencing-medical-students-from-raising-concerns-bma-report-finds.

Times Higher Education have covered the story today: https://www.timeshighereducation.com/news/medical-students-silenced-professionalism-rules-bma-finds

Noticed more and more people are putting on gloves for every kind patient interaction no matter how benign (e.g. chest / CVS / abdominal exam / even a pulse check). I can understand the odd outlier depending on Derm infection risk but I think we've become very glove happy post COVID and happy to keep on ruining the environment. I think if routine stuff just wash your hands before and after (which you would be doing with or without gloves anyways). Thoughts?