Physician & Scientist
@ImperialMed
. I study early-onset type 2 diabetes & MODY. Consultant in Metabolic Medicine. Sometimes I eat 🍫 but you don't have to ☺️
Delighted to share our review for
@TheLancetEndo
on early-onset type 2 diabetes
We use evidence from both adolescents & young adults to provide a contemporary review of type 2 diabetes in people aged <40 years, highlighting latest data & evidence gaps
@C_Pley
Caitlin, if you feel up to it, you should really report this behaviour.
Academia *should be* a safe place for women. The content is so demeaning and this person needs to understand the many ways they have breached professionalism
Schrodingers healthcare worker: so important they shouldn’t be allowed to take holiday but not important enough to have a pay rise in line with inflation.
You chose to share my paper on twitter - 🙏
You generated an interesting discussion - 🙏
You tagged the male professor co-authors - 🙏
But, you didn't tag me, the female 1st author 🙄
You missed out on my contributions.
Maybe it's minor to you, but I judge you for this.
The Head of Nursing said she’d accept full responsibility if anything happened when LL was back on the rota and the consultant on call had raised concerns that she was back on.
Good, we’re waiting, Alison. Please go ahead.
Here’s one more positive tweet and then I’ll get back to normal.
On NYE, I noticed a new follower who has the same surname as me.
Misra is quite common in north India but not many people have that surname over here as most migration came from other parts of the country.
1/
I’m a consultant of 6 years. I’m not striking. I earn 3x the average UK pay. I’m comfortable & don’t need any more money.
In fact, I donate my salary to a charity every month. I live on crumbs and sleep in my car. Nay I have no car! I walk 13 miles to work every day for my pts
..and beaming listening to my Dad reconnect with his long lost family friend ❤️
The hours I spend on this app have now been vindicated FOREVER MORE but if I hadn't been on leave I'm not sure I would've even noticed a new follower with the same surname...
#serendipity
end~
Is everyone getting a boost bar with their booster vaccine or is that just my hospital?
I for one am pleased they are finally getting some recognition as one of the top 5 Cadbury’s bars 🏆
If you agree to chair something it's literally YOUR JOB to introduce & pronounce speakers names CORRECTLY.
It's awful to be in a meeting & have your name screwed up or worse hear "I'm not going to attempt to pronounce that" ... cue laughter
Patient at the end of our phone call:
BTW are you English?
Me: yes, I am
We’re meeting next week and I think one of us is going to be a bit disappointed 😬
Do opticians know how ridiculous it is for short sighted people to try on frames when they want to buy new glasses and not be able to see what their face looks like in the mirror?
moved here but had never managed to make contact.
A few DMs later our Fathers phone numbers are exchanged & within the hour my Dad is talking to his friend that he last saw in 1964, who lives a few hrs away.
I'm astonished that this happened by complete coincidence😱
4/
There are 800 newly qualified doctors today who don’t have a job because there are no training posts.
Every NHS rota currently has gaps.
How can Health Education England not have created / lobbied for funding for extra posts to address our staffing crisis?
PS. And now to introduce
@viziervish
the Misra in question & the other social media protagonist in this story 😊
Thanks Vishal 🙏🏽
We both got to witness our respective Dad’s on the phone to each other and it really was very special ❤️
You’re the RCGP president, you see a GP colleague tweet that they saw 36 patients f2f & instead of using your platform to silence the “can’t get a f2f GP appt” brigade you admonish your colleague for the notion that it was pleasant for a pt to ask ‘how are you’
I’m speechless.
Wow wow wow.
Tony Chambers, chief exec of Chester Hosp at the time telling consultants: “you need to draw a line under this and move on and if you cross that line there will be consequences”
Tony Chambers statement yesterday:
Am I the only person who thought the ‘chill’ of Netflix and chill meant, you know, sitting in jogging pants and eating crisps on the sofa whilst watching Netflix?! 🤦🏽♀️
I discussed this with my good friend & colleague & it makes so much sense that I’m sharing it:
Medical school applications are designed to favour high achievers, type A personality types, people with perfectionist traits, high standards. Then it trains these individuals
This is beyond desperate 😆
Their report states that he has taken a few days off in the UK to attend a wedding. He's allowed to be on leave. He's also a co-chair;
"When the debate is lost, slander becomes the tool of the loser"
I still think about that Indian nurse who ended her life after being pranked by Australian radio hosts who pretended to be members of the Royal Family
Can’t imagine how humiliated she felt and how much she must’ve been admonished by her workplace to be driven to that.
If something is mandatory for you to do you job, you shouldn’t have to pay for it.
e.g
DBS check
ALS certification or equivalent
Royal College exam fees
Portfolio registration fees
CCT fees
The list goes one.
What a con
People of South Asian descent have a higher risk of developing type 2 diabetes, but a lack of research means we don’t understand why. Shivani Misra, this year’s winner of the Precision Diabetes Medicine Award, given jointly by the European Foundation for the Study of Diabetes and…
“Excessive consumption of alcohol is not appropriate in a professional workplace at any time.”
Imagine having to write that line in a report.
What an embarrassment.
Here’s my prediction
Over the next 10 years Doctors will be gradually replaced by “associates” & there will be lots of propaganda about how they’re adequately trained etc
This won’t happen in two places 1) the private sector and 2) abroad
Many doctors will leave & earn good
I sneezed in my German taxi and said “enschuldigung”
And he said “gesundheit” and I said
“Danke” and he said
“Sprechen sie deutsch?” And I said
“Ein bissien”
Thank you German GCSE 🏆
And that's a wrap!
I've just finished my last week of on call as a consultant (hopefully ever)! Feels weird
As of next week, I'm moving to a Senior Lecturer post in
@ImperialMDR
with 80% of my time dedicated to researching early-onset type 2 diabetes
Wish me luck 🎉♥️
Med students who know I’m a consultant sending me emails
Dear Ms Misra,
I know it’s harmless but it happens a lot.
So I now email back explaining the concept of de-titling and de-credentialing & how it affects women Drs. Very politely ofc.
Hope they don’t mind 😬
Thanks all. This has happened on multiple occasions (today/b4). I’m not singling anyone out & have received apologies.
I hope the tweet raises awareness of the issue - I think it is often done unconsciously but really needs to be sorted as it’s super annoying for
#WomenInSTEM
😘
What’s something you’ve been disproportionately ‘told off’ for at work?
As an SHO I said the right lower zone of a CXR looked ‘a bit grotty’. After WR the consultant took me to the side and went ballistic over use of ‘grotty’
#rage
never been able to say ‘grotty’ since
As a consultant, when I’m worried about a vulnerable pt, the single most important thing I can do is to talk to their GP
I’ve had so many chats this year with GPs- every single one helpful with joined up plans. Thanks guys 🙏🏽
This isn’t a revelation, just thought I’d share 🤗
“The Dr in charge of medical training for NHS England has apologised unreservedly to family of medic who took her own life. Dr Vaish Kumar, 35, was wrongly told she needed to do a further 6 months of training before starting a new role. It meant she was forced to stay
@uhbtrust
”
One day people will write books on how the medical profession itself dismantled the medical profession in the UK.
One of the chapters will be about how the system favoured mediocre Clinical Leaders with no vision, who used short term fixes that just created longer terms problems
Painful 8 minutes but I’m so glad this man called in and explained what most brown people in this country know already and what most Conservative party voters actually think about Rishi Sunak
'Rishi Sunak isn't even British!'
Sangita Myska eviscerates this racist caller who says Tory party member won't vote for Sunak because 'he doesn't represent Britain'.
@SangitaMyska
Since I mostly whinge on here, allow me to share some good news:
Say hello to a newly appointed ⭐️Wellcome Trust Career Development Fellow⭐️
I’ll be researching early-onset type 2 diabetes for the next few years.
I am so happy, can’t quite believe it 🎉💪🏽🥰
Thinking about the doctor who was suspended for 6 months because he used his wife’s free travel pass.
Not good for sure but he was fined & suspended because Doctors are held to a higher standard in society (apparently)
But MPs get away with anything?
EXCLUSIVE 🚨: Suella Braverman asked Home Office civil servants to help her avoid a speeding fine and points on her licence by arranging a private one-to-one driving awareness course
Serious Qs over whether she may have breached ministerial code
1/4
Well here’s what I’m left wondering.
After Shipman, doctors were subjected to greater regulation including appraisal, revalidation, feedback etc
It does make me wonder what regulation there is for non-medical staff in Leadership positions - how do we know they’re competent?
@ShivaniM_KC
Do they have any regulatory body/ even any accountability for their actions / inactions as a highly paid and powerful decision maker?! Can anyone show me one example where they even apologise for their incompetenceS.
Consultants who think they have good pay either
1) bought a house > 10 years ago and levelled up or
2) benefit from a middle/ high income earning partner or
3) have a CEA award or
4) do private practice
Have a reality check of which privilege you have.
Consultants who bought their properties 10 years ago: If you couldn’t afford to buy your current property at its current valuation, at the current comparable salary you’d have now, you should probably be striking.
Since I started getting invited to conferences, my Mum will ALWAYS ask me how my presentations go.
So this time, I brought her to India with me (for hols) & yesterday sat her in the front row. She videoed the whole thing & loved it 🥰
For me, it’ll be a lifelong memory 🫶🏽
Did not expect shade from non HCP public re a Doctor wanting to be addressed as Dr and not Ms 🤷🏽♀️
I respond to Shivani from everyone but if you are titling me, use the right honorific or don’t feel upset if I correct you.
What’s wrong with this?
Received an email from a male consultant, sent to me and two other male consultants.
Dear [male colleague], [male colleague], others
I’m ‘others’
BTW the email trail is to specifically seek MY expertise.
Fed up of this
The level of misinformation in this article is genuinely shocking. It actually reads like propaganda
I know everyone needs to earn a living but is there no journalistic integrity left?
All that is left is a significant proportion of the work force who cannot be satisfied by the work they do because they fail to achieve the standards that are intrinsically the reason they were selected to be doctors in the first place.
Does it make sense?
Was just chatting to the new reg and realised that today is my 5-year anniversary of becoming a consultant 🎉
I have nothing profound to say except that ever since I became a consultant I put on 4 kilos and sprouted a lot of grey hair!
Here’s a celebratory clinic selfie 🤳
“Don’t leave having kids too late”
Oh thank you for this unsolicited advice! I was actually going to leave it “too late” but now that you’ve warned me I shall go and get knocked up tonight. I am so grateful for your valuable advice!
The time to end rotational training was when subsidised accommodation for doctors was withdrawn. It’s completely unacceptable to give doctors no choice over their jobs location and then not provide accommodation
Whoever in leadership oversaw that withdrawal - * slow clapping *
Maybe it's time to end rotational training.
Yes it's good to experience different hospitals.
But it's not good for people's lives to have to move every 6 months or one year.
When I was a Med student attached at Southend hosp - there was a surgeon called Mr Ashley Brown & he was just the best teacher & so kind - used to take the firm out to lunch etc
He almost made me want to be a surgeon! I always wonder where he is now. I wish I could say hi 👋
'Dad have you heard of Mr XXX Misra?'
Dad is stunned. Yes, he was their next door neighbour growing up, with sons my Dads age but all contact was lost when Dad moved to England in 1964.
I explain the connection on Twitter, my Dad is shocked. Apparently he'd heard they..
3/
Dear Lemsip makers
Your product tastes vile and I often feel like vomiting after drinking it. But it does work, which is a pain in the butt.
Please change the damn flavours.
Love
S
Words I heard “we should define the role of the PA in the diabetes MDT”
Me: “there is no role for a PA in the diabetes MDT”
When I last checked, we have a full MDT with defined skills.
The PA doesn’t have a role because they’re a replacement for another skilled colleague
Let's be honest, if as a consultant you had to buy a house with a single income mortgage, you wouldn't think that you were remunerated appropriately. You would not be passive about a pay cut in real terms.
All about privilege. Again.
I support
#PayRestoration
for ALL grades
Me on the phone to on call doctor:
“and sorry what was your name?
& your grade? Oh right & did you study medicine? No not the apprenticeship scheme, the 5 or 6 yr degree? & sorry did you sit the Royal College membership exam? Right & does your gMC no start with a letter?
This is an absolute crazy situation on two counts- that PAs with no medical training are advising doctors as the "on call paediatrician " 😳 and that if doctors follow this advice they are legally responsible.
I think if faced with such a situation doctors should ask to speak…
Does anyone else listen to the same song on repeat for months just because there’s a 7 sec segment that gives you goosebumps, the music is so amazing
That’s normal, right?
Apropos of something
If/when my research career tanks I’ll be opening
Books & Samosas
an eatery where you can smell (and eat) samosas and read books and smear sub-continental food aromas everywhere.
So, like any card-carrying child of migrants, my interest was piqued and we started chatting about family backgrounds - where are your parents from etc
I find out that our grandfathers were from the same town. Hmmm is this a long-lost cousin, i think?
I seek out my Dad..
2/
Recently at dinner a consultant colleague was surprised that I had few thousand followers on here.
“What’s your brand? Why do people follow you”
I genuinely was stumped because all I do on here is whinge.
Are you all following me because of my whingeing? 😂😂
Only I could manage to tweet something that would simultaneously unleash the fury of low-carb AND anti-vaxx twitter🤦♀️
My TL is
1/3 SHE IS THE DEVIL FOR EATING A BOOST
1/3 SHE IS THE DEVIL FOR GETTING A BOOSTER
&😂😂
1/3 A TRAVESTY THAT SHE THINKS BOOST IS IN THE TOP 5
This is a joke tweet. It is not aimed at doctors choosing not to strike - I respect your decision. If you’re on twitter enough you’ll have seen the tweet which inspired me.
I know you were all dying to see a picture of me receiving the Precision Medicine in Diabetes prize 🏆 😉
Here you go!
Thank you to
@novonordiskfond
&
@EASDnews
I’m so happy!
Also please note that I got my nails done to match my dress
#commitment
It’s astonishing to me that when the Consultants raised concerns ppl in leadership positions just brushed it off.
Where did they get that confidence from?
I’m trying to imagine someone saying X is harming a patient & me saying “nah, don’t worry about it”
The other day my friend told me that at their Trust management have put motion sensors on consultant desks to find out how often they get used. I believe the rationale is to check whether they are needed as sometimes empty.
I can’t believe someone thought this was OK to do
It’s come to the point where people in positions of authority are suggesting an elf receiving an hourly pay rate > a junior doctor might be OK because the elf doesn’t have any career progression.
I kid you not.
You could not make it up.
Just realised it's my 4-year anniversary of becoming a consultant!
Things I've learnt that make it easier:
1) some people just won't like you & that's OK 👌
2) not every problem is fixable 🔨
3) most clinical issues that worry you are 'grey areas' for all consultants 🔎
I’m sure I’m going to get cancelled for saying this but the people who are not obese who purport to “live healthy lives” and think Ozempic is evil
…have ‘body privilege’
It might be financial, food, home environment, family or even genetic
But it’s still privilege
Im really sorry but “nicey nicey unions” don’t achieve much for their workers
Unions are not there to be nice. They’re there to play hard ball. To call bluffs. To push the envelope. To fight for what their workers deserve.
There’s no polite or kind way to do this
@dieworkwear
it's testament to the education that you are providing the internet that when i first saw that photo, my immediate thought was how great the suit looked
If we don’t need doctors I can revert to Pan B which is to open
“Puri Roll”
My cafe with North Indian food.
Lunch menu
1. Puri with aloo rasa
2. Stuffed paratha
3. Chole Bhatura
4. Samosa chaat
5. Kadhi chawal
6. Arhah dahl w tadka
7. Kachodi / samosa
Who’s coming?
standards you strive for, the standards that make you feel like you’ve done a good job for the patient, the role that gives you the satisfaction you crave, are simply unachievable.
They were often unachievable in my junior doc days (see every weekend ward cover shift which you
Nobody can say the signs weren’t there, when we find ourselves in a 2-tier healthcare system
- a PA driven NHS model with only ‘hub specialists’
- consultant driven private healthcare
Im happy to be quoted as being sensationalist but I genuinely believe this is the plan
2 important parts of the NHS long term workforce plan
1. Medical student expansion
2. PA/AA expansion
One on a u-turn as per report
Another in the midst of debates, turmoils and safety concerns
If I may?
I don’t think this plan is going very well.
I was at a careers event and I was the only non-white ethnicity person speaking.
Afterwards there was networking &
every single person who was in attendance from a minority ethnic background, came to chat to me. I paid attention to this.
That’s the power of representation
It’s easy to train ppl to recognise a disease
BUT
recognising what is normal is actually the hardest part of medicine, which all practicing doctors spend years perfecting, which carries risk & which can’t be distilled into a 2-year course.
That’s being a Doctor.
POV: you finished your all day atypical diabetes clinic and realised it was also your 6 year anniversary of becoming a consultant & had to take an obligatory clinic selfie 🤳
Q - am I a ‘senior medic’ now 😭?!
Got my hair cut and instead of having it blow dried straight I asked the stylist to bring out my natural wavy hair with a hair cream or something.
Well, anyway, turns out my hair is REALLY CURLY
I’m in shock. I never realised how curly my hair is! I can’t share a picture yet
in a way that perpetuates these traits - highlighting the need for attention to detail, hypervigilance, the consequences of misdiagnosis etc without building any resilience - how to deal with uncertainty etc
Then you graduate and parachute into a clinical environment where the
Sorry I know the intention behind this is honourable and commendable, but this is not the answer.
Also this article is written with such a positive spin - as though if all GPs did this we might solve the crisis. I despise this narrative.
…left with low mods and like you had done a bad job) BUT
now they’re ALWAYS unachievable.
And this is why lots of junior doctors / consultants etc want to leave. When you remove all the perks we had (little things that made a diff eg free toast in the mess, the feeling of
It’s been suggested that I need to tweet more diabetes content rather than my usual stuff
So, what do you think of these shoes that I wore to *the diabetes clinic* ?
I know the colours don’t match but it really helped me focus *on diabetes*
😂😂
As a short / petite woman I often feel completely invisible when im walking around in public. People walk directly towards me in my path and do not deviate, I guess expecting me to move out the way.
What would happen if I didn’t move?
Would you ditch your blind date if you were actually on the same tube train heading to the venue and you recognise them from their picture
AND they’re ………
NOT WEARING A MASK?
I would.