Shai @dr_shai Twitter profile

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@OsheaJacksonJr

Shai

@dr_shai

2 years

I was today years old when I learnt that my “housewife” mum at 26yrs, just married and new to the UK, passed her PLAB/USMLEs/MRCP/MRCOG in 1yr. 🤯❤️ She stopped to “be my mum”- restarting medicine as a medic PRHO when I was 17. ❤️👏❤️👏 to all the amazing mums out there.

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Shai

@dr_shai

7 months

MRI Hip today. Radiographer: What music would you like to listen to? Me: Oh I don’t mind. Whatever you’re listening to. Radiographer: We don’t have anything on. We play it into your 🎧. Me: Errr 90s Indie please. 40 mins of constant Hindi music ensues.

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Shai

@dr_shai

3 years

My wife tells me I remind her of a D-dimer. Apparently I’m really sensitive 🥰 But practically, fucking useless and often lead to a huge waste of resource and time... #MedPickupLines

Dr. Shadowgazer

@DShadowgazer

3 years

girl are you a full spine MRI severely degraded by motion cuz you are impossible to read #MedPickupLines

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@dr_shai

2 years

@JimMFelton Credit to @V1CTORGiraffe 👏🏾 👏🏾

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@dr_shai

2 years

Argh… 45min wait to transfer CT images from one trust to another for time critical emergency. However genius ED StR gets the imaging across with Teams. Patient accepted and transferred. Love how resourceful our ED-ologists are. Absolute superstar.

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@dr_shai

1 year

Game on….

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@dr_shai

1 year

Supplementing palliative meds with the patient’s beverage of choice provides some recapture of the often lost autonomy in the dying patient. I am a firm advocate of those who have the ability to chose how they wish to spend those final days/hours being given the right to do so.

Thanh Neville, MD, MSHS

@thanh_neville

1 year

With end-stage #heartfailure & not a transplant candidate, she was tired of recurrent admissions & being tethered to the #ICU . Wanted to die on her own terms. Her only wish before discontinuing life-sustaining meds: a sip of champagne. @3wishesproject_ (shared with permission)

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Shai

@dr_shai

2 years

The slow death of GIM upsets me greatly. The hatred for the Med Reg on call role is an indictment on training in Medicine. I keep defending the need for multi-speciality StRs to develop good GIM skills. But this is my bias and poorly reflects active experience of those in post

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Shai

@dr_shai

1 year

24/7 consultant presence at the front door in our trust has produced a huge amount of efficiency. The flow is better and the morning team have much fewer waiting to be seen. Lesson learnt from strike nights: 24/7 decision making consultant presence is worth investing in.

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Shai

@dr_shai

2 years

Recognising the dying patient remains a huge issue in modern medicine.

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Shai

@dr_shai

1 year

Let’s Gooooooo

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Shai

@dr_shai

2 months

Best way to recognise the value of medical education is to see it in action at fruition. Tell us all about that clinical diagnosis you made from your own clinical gestalt. Where your training, experience and reasoning (conscious or sub) led you to a make an inspired call

Louella Vaughan

@DrLKVaughan

2 months

There is lengthy argument to had here also about cognition and the time it takes to develop good thinking skills. And this isn't context-free and needs lots of knowledge of disease and disease processes. But cos Twitter thread, I will move along. 6/

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Shai

@dr_shai

11 months

Think I have just found my favourite prescription….

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Shai

@dr_shai

6 months

We should be teaching POCUS at medical school and all FYs should be able to do USG cannulation as a minimum skill.

Zack Ferguson

@zackferguson

6 months

Ok but what’s your POPULAR opinion in medicine that will get you in this position?

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Shai

@dr_shai

6 months

Give an inch…

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Shai

@dr_shai

6 months

When the cardiac arrest bleep goes off, the speed at which you attend is dictated by the ward/area in which the event is advertised to have occurred.

Keith Siau

@drkeithsiau

6 months

Ok, what’s your unpopular opinion in medicine that will get you in this position?

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Shai

@dr_shai

11 months

There’s something about this #BBCQuestionTime audience…. Can’t quite put my finger on it.

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Shai

@dr_shai

2 years

@DrBenLovell POCUS….

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Shai

@dr_shai

2 years

Real life depiction of the consultant who consistently offers and completes WBAs….

Alison Cameron 🤍❤️🤍💙💛

@allyc375

2 years

At last I caught on camera the jogger who throws nuts behind him & as a result is recognised by a group of squirrels who run behind him. #SquirrelScrolling

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Shai

@dr_shai

1 year

@techpriest Yahoo chat joined the room.

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Shai

@dr_shai

1 year

“Seeing patients that can be discharged, first” does not reduce LoS. This is not a surprise. Those patients still need Discharge paperwork/medicines/AHP sign off/Social input/transport. For those at the back DISCHARGING PATIENTS: 🚨The Senior WR isn’t the rate limiting step🚨

Marisha Burden, MD, MBA

@marishaburden

1 year

1/ BREAKING: Prioritizing discharging patients first rounding style did not result in earlier discharges! Check out our @JHospMed article! A 🧵

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Shai

@dr_shai

5 months

Monosynaptic reflexes in Medicine: 1️⃣Fluid for ⬆️ Lactate 2️⃣B2-agonists for wheeze 3️⃣NEWS2 >7 = bleep 4️⃣Headache = CTH 5️⃣D-dimer = VTE 6️⃣CRP = sepsis 7️⃣Trop = ACS 8️⃣>80 = ward based ceiling 9️⃣Analgesia = IV paracetamol or IV morphine 1️⃣0️⃣COPD = target SO2 88-92% Keep adding…

Segun Olusanya (He/Him) [email protected]

@iceman_ex

5 months

Myth 2: Hyperlactatemia needs a fluid bolus Ping @cliffreid @pulmcrit The “Lacto-bolo” reflex…

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Shai

@dr_shai

2 years

The ACPs I work with in EM, AIM, ICU make the scope of practice for med trainees much better. The support they provide to the rota ensures an ⬆️ in flexibility to allow better access training, study and annual leave. They are not Drs, nor do they expect to be. We are a team.

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Shai

@dr_shai

2 years

@DoctorMayJay I’m so sorry you experienced this. Racism is deep rooted into the Small Britain psyche.

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Shai

@dr_shai

1 year

I can hear the divisional and departmental leads clambering around trying to sort the rota. ALL FYs/STs/HSTs/non-training Drs, make sure you strike and make your voices heard. DO NOT get guilt-tripped or pressured into covering. Know that the consultants have your back.

Bethan J

@MsBethanJ

1 year

JUNIOR DOCTOR STRIKE DATES ANNOUNCED! FULL stoppage starting the morning of Monday 13th March and ending on the morning of Thursday 16th March. #JuniorDoctorStrikes ✊🏻 (Source: email received from the BMA)

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@dr_shai

1 year

@Jen_Taylor2 @clare_eliza Christmas Day was fucking awful as consultant on call for ICU. It’s a day that tends to be miserable to work (have worked 12 out of 15 since qualified) but not for volume/capacity. Every time I went to ED, it was utter carnage. Traditionally, Boxing Day and 27th are worse.

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@dr_shai

2 years

The use of POCUS in AMU gives me so much joy and makes me (think I) look badass. Todays Highlights: - PICC line insertion - Severe CCF (presenting with liver dysfunction and peripheral oedema) - RV dilatation with PE - DVT - Deep tissue collection - Aortic Regurgitation and LVF

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@dr_shai

11 months

I’ve worked with PAs since 2012. Every department bar none has been made richer for them. Any negativity/concern lost as value realised. The ire of trainees should not be aimed at MAPs or those who support them. It is NHSE and HEE who have devalued training and development.

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Shai

@dr_shai

1 year

Any JDs who are good with kids - Lucrative Babysitting/Crèche pop-up business being created in Norwich 11-15 April. Hours 12 hour shifts. Pay £262/hr

Junior Doctors

@BMA_JuniorDocs

1 year

11-15 April will be the next round of Junior Doctors strike action in England. The Government is still refusing to make a credible offer - or any offer at all - to resolve our dispute. Read more:

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@dr_shai

8 days

It’s a great case with a positive outcome and some learning points. But, 70, in a NH, multimorbid…. I worry about duration of delirium, persistence of lung injury and deconditioning. It shows the discrepancy between NHS and US (?comprehensively insured) healthcare.

IMCrit

@IM_Crit_

8 days

ICU Stories: 70 yo patient, nursing home resident, w hx of dementia / atrial flutter (on anticoag) / hypothyroidism / gout / decub ulcers (among others) is brought to the ED for "altered mental status" and right gaze deviation. Afebrile, normotensive, hr 80s, sat 96% on room air

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Shai

@dr_shai

1 year

@rosieICM Salutatory…..

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@dr_shai

10 months

@RishiSunak Here’s what it means; 1️⃣Payrise remains below inflation - still a pay cut. 2️⃣Increase in pay from the departments own budget - there will be cuts elsewhere 3️⃣Continued underpayment and under resourcing, therefore under valuing public services in the UK. 4️⃣Strikes will persist

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@dr_shai

3 years

I am glad my kid will grow up to “tolerate” Females and BAME…

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Shai

@dr_shai

2 years

@rosieICM For another, more contemporary take…

Joanna Maggs

@joanna_maggs

2 years

Well said @LucyMangan 👏🏻👏🏻👏🏻 #ThisIsGoingToHurt @guardian

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@dr_shai

1 year

It is telling that MSFs are not about actual clinical skills. Are you approachable Are you punctual Can you be understood Do you take ownership Training priorities in a nutshell.

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@dr_shai

1 year

@Lamboozler If another F2 needed to go home at the end of their shift, would that suggest that they are less committed? I am not detracting from the F2, rather questioning if commitment to speciality is only offered to those who have the freedoms and ability to stay?

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@dr_shai

3 years

@andymoz78 @load_dependent To work in a hospital staffed by employees manufactured in 🇿🇼🇿🇲🇾🇪🇪🇭🇼🇫🇻🇳🇻🇪🇻🇦🇻🇺🏴󠁧󠁢󠁷󠁬󠁳󠁿🇺🇸🇺🇾🇻🇮🇺🇿🇦🇪🇺🇦🇹🇷🇹🇲🇹🇨🇹🇻🇺🇬🇹🇳🇹🇹🇹🇴🇹🇰🇹🇬🇹🇼🇹🇯🇹🇿🇹🇭🇹🇱🇸🇾🇨🇭🇸🇪🇸🇷🇸🇩🇸🇭🇰🇳🇱🇨🇵🇲🇻🇨🇧🇱🇱🇰🇪🇸🇸🇸🇰🇷🇸🇮🇬🇸🇸🇧🇸🇴🇿🇦🇸🇰🇸🇽🇸🇬🇸🇱🇸🇨🇸🇲🇸🇹🇸🇦🇸🇳🇷🇸🇼🇸🇷🇼🇷🇺🇷🇴🇷🇪🇵🇳🇵🇱🇵🇹🇵🇷🇶🇦🇵🇭🇵🇪🇵🇾🇵🇬🇵🇦🇳🇴🇴🇲🇵🇰🇵🇼🇵🇸🇲🇵🇲🇰🇰🇵🇳🇫🇳🇺🇳🇨🇳🇿🇳🇮🇳🇪🇳🇬🇳🇱🇳🇵🇳🇷🇳🇦🇲🇲🇲🇳🇲🇪🇲🇸🇲🇦🇲🇿🇲🇨🇲🇩🇫🇲🇲🇽🇾🇹etc...

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@dr_shai

2 years

@DrBenLovell Show them your Imperial Medical School Graduation Certificate?

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Shai

@dr_shai

13 days

Seam bowler.

Neuromed

@Neuromed_

14 days

Spot diagnosis!! #MedEd #MedX

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Shai

@dr_shai

2 years

@RobertCMahon @HeadSmartFellow

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Shai

@dr_shai

1 year

The 25% who will tolerate/thrive being AIM/GIM/OPM specialists are the heros the NHS deserve and the ones it needs right now. They do it because they can. They are the silent guardians. The watchful protectors. The Knights that the rest need to allow them to function.

Ollie Burton

@ollieburtonmed

1 year

Interested to know how many of my colleagues are in this boat - if you are interested in at least one Group 1 medical specialty, is GIM training putting you off applying for that specialty?

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@dr_shai

1 year

@LynnGreigMiller NHS staff. Care home staff. Nursery and teaching staff. Transport staff. Local council staff. All worked exceptionally hard. All sacrificed huge amounts with disproportional infection and mortality rates Can guarantee non had at work parties to let off steam.

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Shai

@dr_shai

1 year

I have ashamedly more than once, printed a discharge summary out on the label printer and once memorably on the wrist band printer. They were amazing, but highly confidential jigsaws.

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Shai

@dr_shai

6 months

HEE continue to take medicine away from the career that was advertised to me in the mid-90s Loss of the firm structure Loss of autonomy Loss of consultant protection Loss of trainee self sufficiency Loss of the one thing that made up for my god-awful looks…

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@dr_shai

2 years

I have huge respect & love for the PA/ACCP/ACP/AA roles. This group want to work ALONGSIDE Drs to provide better overall care for patients and function for departments - not as replacements. To put currently limited PAs into rota gaps without due support is unfair to all.

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@dr_shai

2 years

@mevparekh

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@dr_shai

2 years

@lungsatwork Speaks volumes for your daughter. Attitudes of parents/participants/players - invariably male - at football matches is a huge put off for so many. Toxicity is not selective to public service employment. It is endemic in society.

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@dr_shai

1 year

An ode to the “Tory “fuck everyone that isn’t us” jamboree”

HENRY MORRIS

@mrhenrymorris

1 year

The Papua New Guinea Courier's latest Letter from London.

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Shai

@dr_shai

3 years

@msiuba This is a huge problem throughout all of medicine. The framing of a presentation leads to so many biases, which become incrementally difficult to absolve. There is so much merit to internally questioning the processes a patient has gone through.

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@dr_shai

10 months

Team EoE #ConsultantsStrike @TheBMA

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@dr_shai

1 year

@thomaswoodcock Tom. This is wholly inaccurate - on many levels. Roshana is a senior StR in Orthopaedics. Whatever else, it’s the Easter break, which she is spending with her family. We do not know what her plans are from Tuesday and shouldn’t insinuate. Your tweet is wrong and should be deleted

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@dr_shai

1 month

Case provided by a colleague, which they saw as an F1

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@dr_shai

2 years

Supported assisted suicide Supported woman’s choice over abortion Supported women priests Supported LGBTQ rights Rejected apartheid Rejected religion in politics "a person is a person through other persons" RIP Archbishop Desmond Tutu. The world is a better place because of you

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@dr_shai

3 months

@VaishFamily @parthaskar @AcutemedSarbc I am so so sorry. Reading this causes a huge amount of anger and frustration. I sincerely hope you get Vaish all the recognition that she deserves and it helps put a stop to this maddening approach to person and career management.

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@dr_shai

1 month

All CT requests prior to ICU admission should include the litres of crystalloid given in the preceding 24hrs. It would go a long way to provide clinical correlation for the the bilateral consolidation, pleural effusions and free-intra abdominal fluid seen.

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@dr_shai

1 year

This is solely my opinion: The JD strike is exposing just how far removed many consultants are from basic technological function and bedside care. The fear comes from exposure to the forgotten/unknown. Appreciate I am <4yrs a consultant, but this is beyond infuriating.

Alison Moore

@AliJaneMoore

1 year

The level of concern about the junior docs strike is way beyond that around other strikes. It's not just about hands on deck - it's about how efficiently consultants can use IT systems and how skilled they are at basics like cannulation which they may not have done for some time.

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@dr_shai

1 year

@RoshanaMN Yes Boss.

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Shai

@dr_shai

1 year

#Avenue5 by @Aiannucci is just phenomenal. All those clusterfucks we have endured for the past 12yrs and right now, are beautifully mapped out in an allegory to whatever subject you care for it to represent.

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@dr_shai

3 months

@Dr_BellaR With you on this. Have for a very long time believed that CFS/ME/POTS/IBS are part of a spectrum of autonomic nervous system dysfunction disorders - most often developed as a post-infective event or due to dysregualtion. Post-CoVID only affirms this belief.

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Shai

@dr_shai

2 years

If HEE want the GMC National Trainee Survey to truly represent the state of play in NHS PG medical training, they should release it a fortnight before ARCPs.

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Shai

@dr_shai

2 years

@lovellcook1972 @BellaRoscetti Maybe… just maybe, this profession needs more like Dr Rossetti. Those who know their own worth. Those who realise that without effective pay and conditions, the profession of healthcare will fail to attract and retain talent. More power to all those who take no shit.

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@dr_shai

5 months

Solidarity remains. We all support our Junior Doctors. But this cannot continue. Meaningful negotiations and a resolution to this is what we need.

Junior Doctors

@BMA_JuniorDocs

5 months

📢 STRIKE DATES ANNOUNCEMENT📢 Junior doctors in England to take further #PayRestoration industrial action. The first strike action will take place from 7am on 20 December to 7am on 23 December. The second will take place from 7am on 3 January until 7am on 9 January.

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@dr_shai

7 months

👏🏾Stop 👏🏾Pushing 👏🏾IV fluid 👏🏾in 👏🏾Haemodynamically unstable PE👏🏾

James Horowitz

@jameshorowitzmd

7 months

🔥Why does this data matter? Historical mortality in high-risk #PE is ~30%, largely unchanged over the past 20 yrs Mortality is driven by RV failure - Acute elevations in RV afterload from PE are not well-tolerated, leading to the obstructive shock death spiral

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@dr_shai

10 months

@nysuri It is so callous. I see nothing but two professionals rushed in an understaffed ED, having a minor conflict - seemingly, resolved appropriately. The resultant escalation is vindictive and highly damaging. Agree, the Trust needs to take a hard look at themselves.

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@dr_shai

4 months

POCUS should be a core skill in Intensive Care Medicine…. And General Internal Medicine.

NephroPOCUS

@NephroP

4 months

#POCUS during ward emergencies is associated with improved diagnosis and outcome: an observational, prospective, controlled study. #FOAMed #MedEd #FOAMcc 🔗

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@dr_shai

2 years

If GIM is to live on - and it very much must It has to be incentivised and made desirable. Good quality training by senior medics who clearly love their job Reasonable hours System functionality, where the med StR is not the go to for thrombolysis, rota gaps and rat infestation

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@dr_shai

2 months

@OrthopodReg When you say your travel to them…

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Shai

@dr_shai

1 year

@GoodishIntent

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@dr_shai

1 month

The eye is mightier than the algorithm…

Ognjen Gajic

@ogi_gajic

1 month

#Sepsis

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@dr_shai

3 months

This is very very good.

Thom H🦀

@ThomHall

3 months

@Parody_RCGP

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@dr_shai

2 years

@TharushaGunawa4

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@dr_shai

2 years

@_HenryBolton It is absolutely right and necessary to enjoy the diversity and welcoming attitudes of London and the UK. You Mr Bolton, and all those who question the rights of those who aren’t White and Christian to celebrate their culture, can get in the bin.

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@dr_shai

6 months

@zackferguson Removal of the Conservative Government will reduce the levels of harm the NHS endures.

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@dr_shai

10 days

It’s a shame GIM is taught and deliver ever so poorly - as this is the direct upshot. Excessive consternation and denial of ownership. The result - 24-48hrs awaiting speciality StR review. Further duration of stay waiting for speciality test to occur.

Andrew Davidson

@AndrewJD

10 days

When I was on renal there were a lot of “mild, explainable AKI, please review” referrals. On haem it was “FBC abnormal, please advise”. Now on gastro its “LFTs mildly deranged, kindly review”. When did we all get so helpless at first line investigations?

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@dr_shai

5 months

And Scout makes 5! Welcome to the family girl.

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@dr_shai

2 months

This little one, along with the three bigger ones are so good for my soul.

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@dr_shai

2 years

As four glorious days away from work come to an end, I force upon you three pictures that encapsulate everything that has been close to perfect about the past 96hours…

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Shai

@dr_shai

1 year

The story of Hospital at Night: 8pm. Night shift starts. Team Medicine is two Regs and two SHOs down. F2 sent to manage the wards….

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Shai

@dr_shai

11 months

IMT3 and GIM StR #POCUS Guided procedures crash course @NNUH . Huge thanks to @nnuhPGME for their unending support. Let’s make this a regular thing and get our #GIM StRs POCUS-ing and accredited!

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@dr_shai

1 year

ALL senior NHS position interviews should include a question about demonstrating an understanding and actioning of WRES.

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@dr_shai

3 months

@CommonsHealth Your second tweet is no more accurate 65% of Consultant BMA members voted This is equivalent most elections/referendums since 2001 The offer favoured senior consultants ➡️higher pay ⬆️ & kept the bonuses all other groups sacrificed to pay for the deal. Offer is still sub-par

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@dr_shai

2 years

@mancunianmedic Takes a huge amount of courage & strength to accept one’s situation. Far too many of us continue on a path because we are too proud or too scared to realise it’s not right. I hope have all the time & space you need to recover and return to whatever life you choose want Prof.

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@dr_shai

2 years

Happy Tin anniversary @drNikkiGray ! It’s been an amazing 10yrs. Thank you for being everything that you are! Here’s to another decade of adventures! 🍾🥂

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@dr_shai

2 years

@DrPujaMehta1 @WhistlingDixie4 Live pictures of team IP&C coming to investigate…

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@dr_shai

2 years

The joys that come from teaching #POCUS and watching clinicians flourish.

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Shai

@dr_shai

2 years

@drphiliplee1 “Do you need me to get an extra pair of hands?”

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@dr_shai

3 months

Had to stop a DATIX that was going to be put in re the use of peripheral NA. As a group, we need to actually accept EBM as a concept we respect.

𝙟𝙤𝙨𝙝 𝙛𝙖𝙧𝙠𝙖𝙨 (he/him) 💊

@PulmCrit

3 months

large, prospective study supporting the use of peripheral norepinephrine. extravasation did occur in 35 patients (5%), but it wasn't severe (no patient required surgery or substantial intervention for treatment of extravasation).

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@dr_shai

2 years

@bobbybalmoral Combine them. Everyone satisfied….

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@dr_shai

4 months

The importance of spouses/loved ones who shoulder so much cannot be underestimated. The set up of medicine is not built for working couples, where one does not sacrifice time/career/ambitions. Take a wild guess which particular group is more likely to make the bigger sacrifice.

Tim Ricketts

@timricketts_

4 months

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?

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@dr_shai

1 year

It’s really not that difficult - it’s been done before Invest in the NHS. ⬆️the numbers of speciality training posts ⬆️ the quality of speciality training ⬆️ the numbers of speciality consultants ⬆️ targeted nurse/AHP numbers ‘£73bn economic boost’ of shorter NHS waits

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@dr_shai

2 years

Newest addition to the ⁦ @NNUH_AMU ⁩ family. Welcome to the team special #POCUS friend! Thank you ⁦ @EParker1194 ⁩ and ⁦ @GEHealthcare ⁩

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@dr_shai

2 years

@DrLKVaughan @gmcuk I applaud your 🧵 and agree with much. Is using #BeKind ignoring our ethical tenants? Are the ethics of justice and beneficence outdated? Interesting they aren’t referred to in the proposed document.

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@dr_shai

2 years

@Manoj_Wickram You are 1/8th of the way to getting your patient seen by the Crit care team.

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@dr_shai

4 years

@mancunianmedic I shook hands with the common people, I shook hands and said “whatever” when Dr Whitty ruffled my do. Then I slept with common people I slept with common people like you Well, at St Thomas ICU... I said "Fuck sake, PM, see what complacency can do”

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@dr_shai

10 months

Dying shouldn’t always be a negative outcome. Good medical care can save you from an uncomfortable and tormented end of life.

Sam Ghali, M.D.

@EM_RESUS

10 months

If you could share one medical fact with the entire world that you believe would save lives, what would it be?

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@dr_shai

5 months

Referring to surgery without a diagnostic CT

David 🇵🇸

@paskana_

5 months

what do you think is harder than this?

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@dr_shai

1 year

@doc07_dr @juliaisobela Why don’t you come out into the light and be as honest as you claim to be? That’s right - you have absolutely no integrity or backbone. I’m 💯 sure I’d rather have Julia as my doctor over you.

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@dr_shai

11 months

@MedCrisis The only reason we don’t thrombolyse all STEMIs is cos of Big Cardio.

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@dr_shai

5 months

@IsabelOakeshott @MHA_92_ What’s your evidence for your allegations here? There is a video of a person celebrating having a quantity of money in a bedroom. Can’t hear any speech or see any signs to suggest alternatives. If it’s illegal earnings then he needs to be reported to the authorities?

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@dr_shai

11 months

Excellent to see. Well functioning acute medical units are dependent upon effective staffing and function. The benefits of AMUs on admission, mortality and LoS are well known. So, getting the AMU right should be high on every medical directorates list of priorities. #takeAIM

SAM Online

@acutemedicine

11 months

Full house this morning at #takeAIM23 . Another sold out @acutemedicine conference. Faces of the future of Acute Medicine. Enthused and inspired. Fantastic!!!

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