Nigel D'Souza @mrnigeldsouza Twitter profile | Pikagi

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Nigel D'Souza

@mrnigeldsouza

2,413

Followers

956

Following

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Consultant Colorectal Surgeon @uhsft , trained in 🇬🇧🇿🇦🇦🇺. Research- bowel cancer imaging, FIT.

Southampton, England

Joined March 2011

Don't wanna be here? Send us removal request.

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@mrnigeldsouza

Nigel D'Souza

4 years

My 1st ASGBI conference was in 2011. I failed to get a reg number, or even an abstract that year. This year I'm shortlisted for the @asgbi Moynihan Prize, and CCT in 2021. Surgery is hard. Use your failures to succeed. Never give up. 💪🏾 @asgbi @ASiTofficial @Dukes_Club

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@mrnigeldsouza

Nigel D'Souza

10 months

To understand the medical brain drain from UK to Oz, look at my🇦🇺 fellowship payslip. Fortnightly salary = 12470 AUD = 6528 GBP. = £170 000 per annum as a trainee. UK consultant salary = £88 000 p.a. We will lose our best doctors from the UK if we don’t fix this.

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Nigel D'Souza

1 year

Celebrated my appointment as a Consultant Colorectal Surgeon @UHSFT with 👨‍👩‍👧‍👦 today. A long journey that started in 2002… 🙏🏽❤️ to my wife and kids, trainers and colleagues, for supporting me through the highs and the lows. Can’t wait to come back to the NHS and pay it forward.

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@mrnigeldsouza

Nigel D'Souza

3 years

In a good moment. This week: Last night shift ✓ CCT ✓ House packed ✓ Flying out for 🇦🇺 fellowship @SydneyLHD ✓ Love surgery, but it is tough and 🇬🇧 training is long. Thanks to everyone who helped me get through. Especially my family and wife Charlotte. ❤️

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@mrnigeldsouza

Nigel D'Souza

1 year

Dear NHS colleagues. I've loved working in 🇦🇺. Suggest you work in Aus to experience - better pay - better working conditions - better lifestyle 🏖️🏄 also see - benefits of private/public system - how hard 🇦🇺 docs work - unique benefits of NHS

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@mrnigeldsouza

Nigel D'Souza

4 years

The NICE FIT Study results are out! #FIT will revolutionise the investigation of bowel symptoms. The diagnostic accuracy of this home bowel cancer test was tested in 9822 patients, the biggest study in the 🌍 Free to read in Gut with open access: 1/

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@mrnigeldsouza

Nigel D'Souza

4 years

Very emotional to have won the ACPGBI BJS Prize for our work on FIT in symptomatic patients.... 27 years after my supervisor @muti192 . A lifetime goal achieved. @ACPGBI @BJSurgery

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@mrnigeldsouza

Nigel D'Souza

2 years

Anyone else disappointed by the universally hysterical reaction of our 🇺🇸 colleagues to a 🇪🇺 colonoscopy screening RCT? Total denial of the fact that patient acceptability of this is poor, and that we need better screening tests for our pts. Is this due to income threat 🤔?

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@mrnigeldsouza

Nigel D'Souza

3 years

Can NHS consultants afford to buy and live in a nice house in London without private practice?

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@mrnigeldsouza

Nigel D'Souza

10 months

UK medicine wouldn’t be in such a mess if we respected ourselves and took ourselves a bit more seriously.

@DrNeilStone

Neil Stone

10 months

Full American style here with professional suited photos of incoming specialty trainees. Should we all be doing this in the UK?

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@mrnigeldsouza

Nigel D'Souza

27 days

Find it tragic that so many doctors are questioning @drkeithsiau ’s commitment to medical education for cheap likes. He has researched and published on med Ed, has forma clinical training roles, and tweets Gastro Ed to about 5 million X followers.

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@mrnigeldsouza

Nigel D'Souza

1 year

FOXTROT is published! Reduced recurrence from advanced colon cancer after pre-op chemo. Gamechanger. Time to start staging colon cancer on CT!

Preoperative Chemotherapy for Operable Colon Cancer: Mature Results of an International Randomized...

PURPOSE Neoadjuvant chemotherapy (NAC) has potential advantages over standard postoperative chemotherapy for locally advanced colon cancer but requires formal evaluation. METHODS Patients with...

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@mrnigeldsouza

Nigel D'Souza

3 years

Wasn't going to post about passing my PhD viva. But I asked my wife to pick up some "interesting crisps" to celebrate (school night), and she met the brief so passively-aggressively that I thought it was newsworthy. Well played hon. ❤️

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@mrnigeldsouza

Nigel D'Souza

3 years

ANY red flag 🚩 bowel symptom; test with FIT. Please read our most important data on FIT, broken down by each @NICEComms referral symptom in @BJSurgery @ACPGBI @BritSocGastro 🧵

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Nigel D'Souza

1 year

Asked my patient why she had her colonoscopy. She said her hernia surgeon (private) said he never does an inguinal hernia repair without first doing a gastroscopy and colonoscopy.

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@mrnigeldsouza

Nigel D'Souza

2 years

New FIT guidelines from @ACPGBI @BritSocGastro Anyone with bowel symptoms, test first with FIT.

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Nigel D'Souza

1 year

Tip for surgical registrars. When reflecting for CBDs/CEXs— copy and paste into a document under headings of leadership, teamwork, conflict, patient safety, etc. Will be very useful as an example bank for your consultant interview— wish I’d done it years ago!

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@mrnigeldsouza

Nigel D'Souza

4 years

Tranexamic acid -does not improve survival after GI bleeding -small, but statistically significant increase in VTE. Results from HALT-IT RCT. @TheLancet @ACPGBI @BritSocGastro

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Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in...

We found that tranexamic acid did not reduce death from gastrointestinal bleeding. On the basis of our results, tranexamic acid should not be used for the treatment of gastrointestinal bleeding...

www.thelancet.com

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@mrnigeldsouza

Nigel D'Souza

2 years

Celebrating - 1 year of 🇦🇺🦘 colorectal surgeryfellowship at Concord - 1 week in the new job at Royal Prince Alfred - new house with 😎🚲 commute - 9 years of my wife somehow still loving me!

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@mrnigeldsouza

Nigel D'Souza

4 years

Devastating news... As surgeons, every case like this that we see never leaves us. This is why we spend our mornings and evenings and weekends doing research... To find ways to stop this from happening. Prayers of love to Chadwick's family.

@chadwickboseman

Chadwick Boseman

@chadwickboseman

4 years

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@mrnigeldsouza

Nigel D'Souza

1 year

🇦🇺 vs🇬🇧 🩺 pay 🇦🇺— stay late, auto paid overtime when claimed. 🇬🇧— stay late, no overtime unless via complaint to guardian of safe working. Not enough money in NHS for overtime, but would make such a difference to trainee well-being (and improve patient care) IMO.

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@mrnigeldsouza

Nigel D'Souza

3 years

@D_Rodders Dominic, if your Mum had no veins, would you rather have the surgical reg come down and try 3 times just to avoid this argument, or have an anaesthetist come down with ultrasound and get it in first time? What is better for the patient?!

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@mrnigeldsouza

Nigel D'Souza

5 years

New @BritSocGastro @ACPGBI guidelines for polyp surveillance: no more f/u for pts with polyps previously deemed low/intermediate risk. Could hugely decrease number of surveillance scopes. Thoughts?

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@mrnigeldsouza

Nigel D'Souza

2 years

Big changes coming to bowel cancer diagnosis in sympomatic patients in the NHS. Read more in this 🧵 about 1. Current use of FIT for bowel symptoms in 🇬🇧 2. NICE re-appraisal of FIT 3. New 🇬🇧 FIT symptomatic guidelines 4. Post-FIT outcomes?

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@mrnigeldsouza

Nigel D'Souza

3 years

Northern Ireland following the science, to produce pioneering national guidelines of FIT-based management of symptomatic patients. Major, major piece of work from multiple stakeholders to improve colorectal cancer diagnosis for patients. 👏🏽👏🏽👏🏽

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@mrnigeldsouza

Nigel D'Souza

2 years

🇬🇧 vs 🇦🇺 hospitals no. 9: colonoscopy sedation 🇬🇧: midaz + fent 🇦🇺: propofol GA w/anaesthetist Many arguments against propofol. But what I've observed: - zero pain - MUCH quicker (surprisingly)

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@mrnigeldsouza

Nigel D'Souza

5 years

@NHSMillion @NevilleSouthall @GaryLineker @Dynamomagician @mrjakehumphrey @ClaudiaWinkle @TomDaley1994 @gdavies @RomeshRanga @HKane @DrAlexGeorge NHS saved my kid Harry when he was born 6 weeks premium and couldn't breathe for himself. World class care @GSTTnhs for which I'll always be grateful.

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Nigel D'Souza

3 years

Fascinating results from @KatyNewton17 on packing after I+D of perianal abscess in PIPAC2 study. No difference in recurrence or fistula rates, more painful than not packing. Packing not done in 🇺🇲-- can we stop in 🇬🇧? What happens in 🇦🇺? #ACPGBI2021

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@mrnigeldsouza

Nigel D'Souza

3 years

Early onset colorectal cancer (EOCRC) in younger patients <50 is a very very difficult problem. We worked with @kevinjmonahan and @Lisa_Wilde from @bowelcanceruk to see whether FIT could help avoid delayed diagnosis. The results were interesting... 🧵

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@mrnigeldsouza

Nigel D'Souza

1 year

Trainee colleagues in the NHS. Please strike for fair pay. And withdraw emergency care. It goes against every fibre of your being. But otherwise the best doctors will not be treating you or your family— they will have left the job or the UK, like many docs I meet in 🇦🇺.

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@mrnigeldsouza

Nigel D'Souza

3 years

Born in Huddersfield. Now Surgeon General.

@vivek_murthy

Vivek Murthy

3 years

Honored to be sworn in as your Surgeon General. I owe this day to my family who has guided & supported me every step of the way. I stand ready to work with you to end this pandemic & build a world where good health is within everyone’s grasp. Follow @Surgeon_General for updates.

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Nigel D'Souza

3 years

🇦🇺 hotel quarantine is ok! Food: mostly good HQ staff: so nice Kids (3): coping v well, no meltdowns Luggage: everywhere Me: no meltdowns also Spin 🚲: keeping 👩🏼‍🤝‍👨🏾 sane Views: phenom Lucky to have got here. #🦘

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@mrnigeldsouza

Nigel D'Souza

4 years

In the wake of #ChadwickBoseman 's death, GI docs are reflecting on how we can best stop further tragic deaths from #ColonCacncer in the young. My take-- I think we need to be honest that at present, we do not have the tools we need to effectively address this problem. 1/thread

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@mrnigeldsouza

Nigel D'Souza

3 years

Immediate thoughts upon looking outside with kids. 1. Snowman 2. Surprise snowball attack on mother-in-law 3. PhD corrections ain't getting done today.

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@mrnigeldsouza

Nigel D'Souza

3 years

Incredible to think how 2 consultant surgeons at a little DGH @croydonhealth started a research programme >20 years that launched the careers of so many surgeons. Best years of my life.

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@mrnigeldsouza

Nigel D'Souza

5 months

I made it! 🤴🏾🤣

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@mrnigeldsouza

Nigel D'Souza

2 years

My @cochranecollab review on "MRI in Appendicitis" was just published. Was quite topical when I started it in 2015... before my 3 kids, PhD, Trump Presidency, COVID, etc! Please have a read.

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Magnetic resonance imaging (MRI) for diagnosis of acute appendicitis

www.cochrane.org

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@mrnigeldsouza

Nigel D'Souza

2 years

A lot of 🇬🇧 surgeons are interested in moving to 🇦🇺 to work. This is what I’ve learned about the process when post CCT. Spoiler: not easy. Steps: 1. Application + fee 2. Interview 3. Further training/exam 4. Supervised practice 5. Getting a job 6. Private practice moratorium

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@mrnigeldsouza

Nigel D'Souza

2 years

I read the papers and looked at the models behind the USPSTF colon cancer screening guidelines and could not understand how/why the screening age was lowered to 45. This analysis explains exactly why I was so dumbfounded. Please read 👇🏽

@VPrasadMDMPH

Vinay Prasad MD MPH

2 years

#12 the USPSTF was off their rocker to lower the age of CRC screening using modeling We should base screening on RCTs not models In case you live under a rock: models are not reliable

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@mrnigeldsouza

Nigel D'Souza

10 months

@veedub3057 Yes, but lots of UK docs work beyond their contracted hours — we just don’t get paid for it!

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@mrnigeldsouza

Nigel D'Souza

1 year

What is Lloyd Davies position? Lithotomy (15 deg hip flex) + Trendelenburg (30 deg head down). Intended to permit simultaneous abdo + perineal approaches to rectal cancer.

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@mrnigeldsouza

Nigel D'Souza

10 months

@liverpoolmedic Yup. Including a weekend. But you get paid for your overtime here. Hard work gets rewarded. Unlike the guardian of safe working debacle.

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@mrnigeldsouza

Nigel D'Souza

4 years

@doctornickg @LFDerbyshire Well.. maybe we deserve it. So many medical students get ignored on attachment during speedy WRs or during long complicated cases, unless they're getting (pointlessly) quizzed on random anatomy. I thought most surgeons were dicks when I was in med school. We need to do better.

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@mrnigeldsouza

Nigel D'Souza

2 years

What a phenomenal ultrasound diagnosis; ascending colon diverticulitis in 24F c RIF pain. How often do you see ultrasounds of this quality for RIF pain in your practice?

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@mrnigeldsouza

Nigel D'Souza

4 years

Huge honour to be presenting data from NICE FIT study in the @BJSurgery Prize Session @ACPGBI . Please tune in to see how FIT could change practice. 9am, Sun 5 July.

@ACPGBI

@ACPGBI

4 years

The @BJSurgery Prize live - Sun 5 Jul chairs @austin_acheson @MissLHancock @PVaughanShaw Best of luck to our finalists! @SJ_Chapman @mrnigeldsouza Amy Lord @KatParmar Sandeep Singh Toritseju Sillo Reports from @ASCRS_1 @CSSANZ2 @SACRS6 by @TorkiJ ➡️

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Nigel D'Souza

3 years

This is how my mates congratulated me on being shortlisted. The 🇬🇧 sense of humour-- so good, and so mean. 🤣🤣🤣

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@cam_colorectal

Nicola Fearnhead

@cam_colorectal

3 years

Very best of luck to four finalists in @ACPGBI #traineecoloproctologistoftheyear 2021. Formidable line-up @mrnigeldsouza @HelenMohan1 @KSahnan @PVaughanShaw #futureisbright #colorectalsurgery

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Nigel D'Souza

3 years

More data supporting FIT... how much more is needed before NICE change 2WW criteria?!

@CRiPS_UoD

CRiPS | UoD

3 years

Faecal haemoglobin concentration thresholds for reassurance and urgent investigation for colorectal cancer based on a faecal immunochemical test in symptomatic patients in primary care - 2021 @BobSteele6 @jstrachan10

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@mrnigeldsouza

Nigel D'Souza

1 year

10% of nurses leave the NHS each year. Below, view from a private 🏥 in Sydney where 90% nurses from 🇬🇧🇮🇪. None planning to return. Spoke to Chloe who qualified in Birmingham and made 22 AUD/hr equivalent. She now lives on Bondi beach and makes 42 AUD/hr.

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@mrnigeldsouza

Nigel D'Souza

2 years

Advice to my junior surgical colleagues, from my own bitter experience. If you are worried about a patient, but obs and bloods are normal, get a CT. It is hard, but do not let confrontations with radiology about "can it wait" stop you from advocating for your pt.

@SharanWad

Sharan Wadhwani

2 years

@mrnigeldsouza @aaoplumb @wannabehawkeye @MarkarSheraz @EwenGriffiths @RCRadiologists @davidnnaumann The acute abdomen should be scanned. Is a staging scan appropriate OOH? Is a reassurance scan to exclude any pathology with no positive signs/normal bloods? Many of these are pushed through under the guise of patient flow. Does OOH = acute care or 24/7? Is 24/7 resourced?

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@mrnigeldsouza

Nigel D'Souza

4 years

This is why colorectal surgeons need to be involved in therapeutic colonoscopy. @ACPGBI @Dukes_Club @DrSarahCMills @JAG_Endoscopy

@SamAtallahMD

Sam Atallah, MD 🇵🇸

4 years

Glimpse the future @ESSOnews #TAMIS @ManishChandSurg @TAMISYoda @gagliarg @TechColoproctol @fascrs_tech @ASCRS_1 @JoshuaTylerMD @DavidKleimanMD @MarkSoliman @patsyllamd @JohnMarksMD @SRSLATAM @SAGES_Updates @socroboticsurg @omaale7 @albertoarezzo @BardakciogluMD

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Nigel D'Souza

3 years

Use FIT in patients with rectal bleeding 🩸🚽 Study led by @GeorginaHicks published in @ColorectalDis Excellent infographic summary! 1/3

@GeorginaHicks

Georgina Hicks

3 years

Check out our exciting research in @ColorectalDis Talking about FIT and why it should be used in patients with rectal bleeding @mrnigeldsouza @muti192 @nicefitteam @ACPGBI #colorectalcancer #Cancer #coloncancer #research

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Nigel D'Souza

1 year

Do we need to discuss all patients with newly diagnosed colorectal cancer in an MDT? Or does this mean discussions of complex cases are rushed?

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@mrnigeldsouza

Nigel D'Souza

4 years

Tumour deposits and EMVI on pre- CT can identify high risk sigmoid colon cancer. A better way of staging colon cancer on CT needed after FOXTROT. #colorectalresearch Thanks to my co-authors @prof_gina_brown @ParisTekkis @muti192 @AmyLord1 @Annabelmshaw

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Staging System for Sigmoid Colon Cancer Based on Computed Tomography Findings

This prognostic study assesses whether preoperative computed tomographic findings can be used for sigmoid colon cancer prognosis.

jamanetwork.com

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@mrnigeldsouza

Nigel D'Souza

4 years

@Aleexxies I'm pretty sure the surgical team don't want you to move in with them Alex. Trust me on this one.

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Nigel D'Souza

3 years

In 🇬🇧, overnight CTs for abdo pain only done if pts might need emergency surgery that night. When will we be able to get diagnostic CTs on admission instead of waiting for the following day? I think it would vastly improve our service to patients. Is just a 💰💰 issue?

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@mrnigeldsouza

Nigel D'Souza

1 year

Coffee post ward round on Australia Day at RPA. 🇦🇺🦘 Consultants like Dr Ng see every colorectal patient on public holidays/Sat&Sun, and supervise every elective and major emergency operation. Excellent care for public patients is possible in dual public/private systems.

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Nigel D'Souza

3 years

Will post some interesting differences in surgical life/practice between 🇬🇧 and 🇦🇺. No. 1: 🇦🇺 7am WR start! But also 8am theatre start, and 4:30pm home time. Prefer these timings as 👨🏾‍🦳 with kids, but wouldn't have as F1 with a social life.

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@mrnigeldsouza

Nigel D'Souza

2 years

Robotic versus laparoscopic surgery for middle and low rectal cancer (REAL). What do people think? @DeenaHarji @MGudgeon @DaniloMisko @JimkhanMD @MarkSoliman

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Robotic versus laparoscopic surgery for middle and low rectal cancer (REAL): short-term outcomes of...

Secondary short-term outcomes suggest that for middle and low rectal cancer, robotic surgery resulted in better oncological quality of resection than conventional laparoscopic surgery, with less...

www.thelancet.com

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@mrnigeldsouza

Nigel D'Souza

2 years

Did an anterior resection with Brendan Moran the other day… nominally I was the operating surgeon, but it felt like he did about 90% of the operation with the St Marks and sucker!

@rbarbosa91

Ron Barbosa MD FACS

2 years

One may be tempted to think that the person with the knife has the most important role here. But very often, it is not so. Often, the greater skill is required to hold traction and countertraction in exactly the right way so that the tissue can be divided properly.

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Nigel D'Souza

3 years

For me, the best thing about @debby_keller is that she is fun. On top of being ridiculously hard working, super bright, extremely personable, she is just really fun and enjoyable to be around. So pleased to see you on this list Debby.

@Dukes_Club

The Dukes' Club

3 years

2nd of our #colorectalwomen today.. @debby_keller , described by trainees as someone they look up to & aspire to be. Sounds like a great #RoleModel #WomensHistoryMonth #ILookLikeASurgeon @UCDavisSurgery @WomenSurgeonsUK

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Nigel D'Souza

9 months

Genuine question re overnight operating. Is it unsafe for an ASA 1-2 patient to undergo appendicectomy after hours with an experienced anaesthetic and surgical registrar? Should we not be doing this to expedite pt Rx and ⬇️ pressure on the emerg list? @NCEPOD @asgbi @RCoANews

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Nigel D'Souza

3 years

Most colorectal trainees want to become expert colonoscopists. But problems with colonoscopy training are well recognised. These are the steps recommended by @Dukes_Club and @ACPGBI to improve training, so we can provide the best service to our current and future patients.

@ACPGBI

@ACPGBI

3 years

Joint ACPGBI and The Duke’s Club statement on colonoscopy training

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@mrnigeldsouza

Nigel D'Souza

4 years

@SultanMahmoodMD @GIDrDon @drkeithsiau @stevenbollipo @AllonKahn Sultan, disimpaction will treat your pt in <5 min. Tips I've learned: 1. Gloves, liquid soap, more gloves (hands w smell) 2. Inco pads +++ 3. Disimpact until rectum clear 4. Give enema yourself stat and put pt head down (trickles up L colon). Gets pts home in<1 hour.

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Nigel D'Souza

3 years

🇬🇧 vs 🇦🇺 hospitals no. 2: 🇦🇺 surgical reg - theatre 5 days a week 😮 (at Concord). No clinic or ward round commitments. 🇬🇧 surgical reg- theatre 1.5 days/week (average?) Which job would you rank 1st choice in your deanery?

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@mrnigeldsouza

Nigel D'Souza

2 years

Previous colorectal fellows at Royal Prince Alfred @SydneyLHD . Going back to 1996– before some of our current interns were born. Some might find it cringeworthy, but I love this kind of thing; history and pride in the profession. Stopped 5 years ago… they should restart!

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@mrnigeldsouza

Nigel D'Souza

1 year

@trentconsultant @UKLabour Was just chatting with some Australian junior doctors about UK consultant pay. They were flabbergasted. Could not understand why anyone would spend so long training for that salary.

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@mrnigeldsouza

Nigel D'Souza

2 years

@JoanneBell5 Hi Joanne. I stayed/stay late to operate on my patients if I’ve clerked, diagnosed and prepped them for a laparotomy. It’s why we become surgeons!

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@mrnigeldsouza

Nigel D'Souza

3 years

Would colorectal trainees benefit more from 6 months of immersion endoscopy training or 6 months of breast surgery? Thought-provoking comments from @lapcoleadmark as head of @JAG_Endoscopy . #ACPGBI2021 @Dukes_Club

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@mrnigeldsouza

Nigel D'Souza

3 years

🇬🇧 vs 🇦🇺 hospitals no. 3: 😋 hospital coffee in 🇦🇺 🤮 hospital coffee in most of 🇬🇧 Why have we allowed a monopoly (✖️a ☕) to take over 🇬🇧 hospitals, and mug us for £100s/year for bad coffee. 🤦🏽‍♂️

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@mrnigeldsouza

Nigel D'Souza

2 years

Anyone else getting a lump in the throat whenever they read or talk about @bowelbabe ? Can’t stop thinking about her, her kids and husband Seb abut also other young patients I’ve seen with bowel cancer.

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@mrnigeldsouza

Nigel D'Souza

4 years

FIT in high + low risk symptomatic patients-- pilot results published @RCSnews . Thanks to our collaborators listed below. Can FIT be used to triage high risk pts for further investigation? #colorectalresearch @ACPGBI @cripps_neil @lapcoleadmark @stevenbollipo @drkeithsiau

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@mrnigeldsouza

Nigel D'Souza

3 years

Love this. But still pretty alien concepts in surgical training tbh.

@Cooper00Nicola

Nicola Cooper

@Cooper00Nicola

3 years

⁦ @bodgoddard ⁩, speaking at our Med Reg leadership course ⁦ @UHDBTrust ⁩ , tells us to think like a farmer 👇

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@mrnigeldsouza

Nigel D'Souza

4 years

@trishgreenhalgh We're still waiting for 7 day working weeks in the NHS! These empty promises unlikely to come to anything and just reflect how Matt Hancock is terribly, terribly out of his depth...

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@mrnigeldsouza

Nigel D'Souza

4 months

Busy wknd on call for gen surgery @UHSFT as per usual. Made easier by a great set-up: - subspecialty consultant ward rounds for every pt, also available if needed in theatre - enthusiastic and capable on call team inc brilliant ANP (80% born abroad)

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@mrnigeldsouza

Nigel D'Souza

5 years

@schoolofsurgery Don't think it's a surprise that there was a paeds cardiothoracic scandal at his unit.

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@mrnigeldsouza

Nigel D'Souza

10 months

@iDrSunny @DrAsifQasim Sydney is bloody expensive Sandeep. Doctors take out mortgages for $4-8 million dollars. Childcare and private schools very expensive.

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@mrnigeldsouza

Nigel D'Souza

9 months

NICE guidelines officially updated for patients with 2WW bowel cancer symptoms (DG56) Test with FIT. 👍🏽

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@mrnigeldsouza

Nigel D'Souza

3 years

I hope FIT will help our colleagues in primary care, who see millions of patients with bowel symptoms, and have to decide who needs referral for urgent investigation. Already used by GPs in 🏴󠁧󠁢󠁳󠁣󠁴󠁿. @drmarkporter @ClareGerada @DoctorMayJay @DrHilaryJones @rcgp @BMA_GP @GPonlinenews

@mrnigeldsouza

Nigel D'Souza

3 years

ANY red flag 🚩 bowel symptom; test with FIT. Please read our most important data on FIT, broken down by each @NICEComms referral symptom in @BJSurgery @ACPGBI @BritSocGastro 🧵

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@mrnigeldsouza

Nigel D'Souza

2 years

Last few years, overnight CTs in my pts with normal obs/bloods; closed loop SBO/LBO, perf DU, perf appendix, torted ovary, AAA. And a few pts with faecal loading/NAD. You will not always have the correct differential diagnosis. Doesn't matter. Early CT is essential for best care.

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@mrnigeldsouza

Nigel D'Souza

2 years

I was lucky enough to train in endoscopy as a CST, and it was part of why I decided to specialise in general surgery. We need to inspire the best CSTs to join our specialty.

@Bhaskar23859803

Bhaskar Kumar

@Bhaskar23859803

2 years

Please encourage your surgical CTs to start endoscopy training. Proud to see my current CT Teri hit 30 gastroscopies already. Endoscopy exposure is essential to learn GI pathology. Well done Teri.

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@mrnigeldsouza

Nigel D'Souza

2 years

RCT Colonoscopy screening vs not. Age 55-64 42% uptake 455 scopes to prevent 1 CRC CRC mortality 0.28% vs 0.31% All cause mortality 11.03% vs 11.04% This is why research needs to inform policy, not just modelling C

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@mrnigeldsouza

Nigel D'Souza

4 years

FIT will change the way we investigate bowel symptoms. @BritSocGastro @JAG_Endoscopy @BSGAR_UK And hopefully lead to earlier treatment of CRC and better outcomes for patients. @Dukes_Club @ACPGBI @ASCRS_1 @escp_tweets @bowelcanceruk @PHE_uk Comments and feedback welcome 7/

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@mrnigeldsouza

Nigel D'Souza

10 months

Looks like FIT will shortly be endorsed by NICE to become part of the 2WW pathway.

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@mrnigeldsouza

Nigel D'Souza

4 years

I am very pleased to see that colonoscopy remains an indicative procedure for CCT; an aspirational target to drive improvements in access to training. We need to now also drive up the quality of colonoscopy provided by surgeons. @Dukes_Club @ACPGBI

@shahabsiddiqi

Shahab Siddiqi

4 years

Indicative training numbers by CCT - Gill Tierney ⁦ @Dukes_Club ⁩ ⁦ @ACPGBI ⁩ #ACPGBI2020

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@mrnigeldsouza

Nigel D'Souza

3 years

So important to see successful surgeons talk about the struggles they faced in their career. Failures can be devastating, but can also be opportunities to learn and improve. Thanks @EwenGriffiths .

@EwenGriffiths

Ewen A Griffiths

3 years

13. Fundamentally I believe that the failures and set backs were profoundly influential in who I have become today. They are me. Looking back I wouldn’t change a thing; despite all the worry and the stress along the way. #NeverGiveUp

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@mrnigeldsouza

Nigel D'Souza

5 years

@emergencyemily Take 5 min to eat a sandwich and drink some water. Even if while writing notes. You have to look after yourself on these busy shifts if no one else is! Good luck.

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@mrnigeldsouza

Nigel D'Souza

6 years

@DavidNNaumann I pretty much stopped caring about this as an F1 when I realised it was not going to get me flight upgrades!

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@mrnigeldsouza

Nigel D'Souza

1 year

@Lamboozler We have built a system that makes it difficult for doctors to work hard and pursue excellence. Depressing.

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@mrnigeldsouza

Nigel D'Souza

2 years

Breath testing could revolutionise bowel cancer screening. So many congratulations to the authors of the COBRA1 study inc @DrWoodfield @DrAmandaJCross @kevinjmonahan @ckontovo

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@mrnigeldsouza

Nigel D'Souza

3 years

Unpopular opinion (yet again). Many 🇬🇧 surgical StRs already breaking EWTD to get decent training i.e. coming in on zero days. IMO not possible for many (inc me) to train within EWTD and meet service reqs. We don't need to work 80+ hours/wk, but 48 is too little to train. 1/2

@drphiliplee1

Dr Philip Lee

3 years

Sure Tom, next time you're in hospital we'll be sure to find you a doctor who's at the end of a 104 hour week to take out your appendix. Sounds good?

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@mrnigeldsouza

Nigel D'Souza

3 years

I find this so upsetting. I worked for Omer Karim as an SHO, and he was a deeply impressive person and surgeon. Where is the accountability from the GMC for the devastation they have wrought?

@ShafiAhmed5

Prof Shafi Ahmed PhD FRCS

3 years

The Reading Employment Tribunal has upheld the complaints made by surgeon Mr Karim, that he was discriminated against by the @gmcuk on the grounds of his race. A landmark decision. How do we trust the GMC? @DrAsifQasim @MrTimLane @RCSnews

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@mrnigeldsouza

Nigel D'Souza

2 years

FIT discussed in @nytimes as alternative to screening colonoscopy. Will FIT take off in the USA? One opinion from US doctor mentioned below.

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@mrnigeldsouza

Nigel D'Souza

1 year

3 lies of surgery - it will only take 5 minutes - we were nowhere near that structure - it was dry at the end told to me by @GoffredoPaolo , my friend from 🇺🇸. Too good.

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@mrnigeldsouza

Nigel D'Souza

2 years

One of my favourite things about 🇦🇺 medicine is working with lots of 🇨🇳 doctors. Going to miss our brilliant surgical trainees on the colorectal team. Strongest work ethic, always laughing and taught me about malatang.

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@mrnigeldsouza

Nigel D'Souza

4 years

Nothing to do with surgery, but so important and so unbearably depressing to read about.

@BBCNews

BBC News (UK)

4 years

I was told "very loudly to get out of the courtroom" Black barrister Alexandra Wilson says court staff mistook her for a defendant three times in one day

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@mrnigeldsouza

Nigel D'Souza

10 months

@LeylsTurk @StevenMAlderson Hi Leyla. I was here as a post-CCT fellow. But actually this is the same contract as the registrars.

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@mrnigeldsouza

Nigel D'Souza

3 years

For attn of int'l colleagues; please share with others! 🙏🏽 🇦🇺 @mjfxrsurg @stevenbollipo 🇧🇷 @R_Perez_MD 🇨🇦 @DrJonnys 🇭🇰 @RashidLui 🇮🇳 @SirohiBhawna 🇮🇹 @GianlucaPellino 🇲🇽 @draivsdawrld 🇵🇱 @KM_Pawlak 🇿🇦 @deanlute 🇪🇸 @juliomayo 🇦🇪 @dubaicolorectal 🇺🇲 @AasmaShaukatMD @SWexner

@mrnigeldsouza

Nigel D'Souza

3 years

ANY red flag 🚩 bowel symptom; test with FIT. Please read our most important data on FIT, broken down by each @NICEComms referral symptom in @BJSurgery @ACPGBI @BritSocGastro 🧵

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@mrnigeldsouza

Nigel D'Souza

6 years

@chops_shell @doctor_oxford @JKCorden Well done to you for supporting your daughter! So much respect for anyone going into nursing these days. Hard job with not enough recognition.

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@mrnigeldsouza

Nigel D'Souza

1 year

How often does recanalisation of the SMA for acute/chronic mesenteric ischaemia work? I've never seen it done succesfully (open or endovasc). What is the experience of others?

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@mrnigeldsouza

Nigel D'Souza

3 years

Another unpopular opinion. I've worked 24 hour shifts in UK + abroad. In quiet and busy hospitals. I prefer it. Better than nights for health, minimises disruption to training/family, and no impact on patient safety.

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