Rattled Doc @rahttled_doc Twitter profile

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Rattled Doc

@rahttled_doc

1 year

Dear @SteveBarclay , There seems to be a lot of interest on UK #MedTwitter ( @RoshanaMN ) in how enticing Australia is for UK docs. Here are a few examples, from a junior doctor who made the move, of the international market you're competing with. You should be worried.🧵

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Rattled Doc

@rahttled_doc

11 months

A snapshot of UK doctor numbers in a single department, in a single hospital, in Australia. As of today our ED has : 26 UK trained Resident Medical Officers 23 UK trained Registrars 10 UK trained Consultants Pay your staff what they're worth @SteveBarclay or lose them

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Rattled Doc

@rahttled_doc

11 months

Hey @NHSEngland , @NHSScotland , and UK #Medtwitter Those UK doctors who moved to my Aussie ED realised we never had an Exit Interview. We never got to share some of the examples of NHS culture that drove us away. Perhaps we can inform you a little with some anecdotes? 🧵

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Rattled Doc

@rahttled_doc

1 year

2. We are paid for all the hours we work. If you work more than 76 hours in a fortnight every one of those hours are paid at time and a half. Work more than 110 hours in a fortnight? Now you're on double time. I was just expected to do all that for free in the UK.

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Rattled Doc

@rahttled_doc

1 year

4. Salary Sacrificing As employees in the public health system we can take a tax free portion of our salary and use it to pay rent, mortgage, or even just for boozy brunch after nights. A recognition for working in the public system. Is that an odd concept for you?

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Rattled Doc

@rahttled_doc

1 year

3. Generous (easily accessed) additional payments for unsocial hours Don't get a break? 50% on top of base pay A late shift? 15% Nights? 25% Sundays? 100% Public holidays? 150% ED hours get me approx. 92,000 GBP p.a. (for approx. 20% less hours than in the UK)

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Rattled Doc

@rahttled_doc

1 year

5. Professional Development Funding / Leave In the UK I had to fight for meagre funds to help me progress as a doctor. They wouldn't even fund ALS. Here I get $8500 a year, and an extra week of leave, to use on equipment, courses, travel, etc to help me be a better clinician

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Rattled Doc

@rahttled_doc

1 year

I hope @BMA_JuniorDocs are successful in their fight for #FullPayResoration . It's only the start of what they deserve. But if they are unsuccessful, I can take solace that our workforce will swell with those with no future working in the UK. Australia is hungrily circling...

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Rattled Doc

@rahttled_doc

1 year

I should also add that all this is protected by a strong union here ( @sasmoa4doctors ) and now that the @BMA_JuniorDocs is strong again I'm sure you can achieve similar

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Rattled Doc

@rahttled_doc

1 year

9. Staff Respect Our CEO regularly joins us to discuss the issues we're experiencing and actually works to correct them. Our ED director also attends our weekly meeting for junior doctor issues. In the UK it was "if you don't like it just leave" approach. So we did.

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Rattled Doc

@rahttled_doc

1 year

11. We're listened to by a Health Minister who meets with us (I hear this is a foreign concept for you) State Minister for Health @PictonChris has repeatedly taken the time to come and meet with us to better understand the pressures we face. Wild eh? Maybe ask him for tips

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Rattled Doc

@rahttled_doc

1 year

6. True Protected Teaching I am guaranteed to receive 5 hours of dedicated teaching time weekly (often catered). That's in addition to the training I get from seniors with the time to teach on the shop floor. In the UK it was inevitably cancelled for service provision.

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Rattled Doc

@rahttled_doc

1 year

7. Flexibility of hours I don't have to fight for hours conducive to family life, or that protect my mental health in the lead up to exams. Instead I can easily meet with my dept leads and be granted (actual) half time, etc I couldn't even attend funerals or weddings in the UK.

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Rattled Doc

@rahttled_doc

1 year

10. Work Life Balance Many of our juniors from the UK travel as a couple and it is understood, and supported wherever possible, that they will work the same hours and rotate to the same jobs when possible so they can actually have a relationship rather than being flung far apart

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Rattled Doc

@rahttled_doc

1 year

For context, I work in a Metro ED with dozens of UK doctors and can go whole shifts where every doctor I work with is from the UK or Ireland. A colleague even had an entire inpatient ward round performed in Irish. @Xeon4f145d96s1 @BMA_JuniorDocs @ShaunLintern

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Rattled Doc

@rahttled_doc

1 year

8. Flexibility of leave Gone are the days of having to fight in the UK to be allowed to go to funerals, weddings, etc. 5 weeks of annual leave 1 week of Development leave 1 week of study leave COVID leave separate from sick leave Leave for exams And on and on....

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Rattled Doc

@rahttled_doc

6 months

New EM OSCE Question : Angry patient lashes out at the urine bottle on the end of their bed while leaving. Bottle lands perfectly on its end sealing the urine in........until you lift the bottle. How do you proceed?

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Rattled Doc

@rahttled_doc

1 year

@BMA_JuniorDocs No i'm not on commission and i've got nothing to do with recruitment. All I ask is that if you decide to come across you transport an appropriate quantity of UK snacks for me

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Rattled Doc

@rahttled_doc

1 year

1. Base Pay (for working 10 hours less per week than the UK) This starts at approximately 43,500 GBP for an FY1 equivalent and peaks at 77,000 GBP for someone just prior to Consultancy. Remember though this is just base pay....

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Rattled Doc

@rahttled_doc

11 months

2. As an FY2 @BlackpoolHospED my Registrar had full blown gastro on a night shift. The consultant refused to take her place for the night. She lay on a bed in resus and the juniors had to stand distant from her and ask her advice on how to manage while she vomited repeatedly

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Rattled Doc

@rahttled_doc

11 months

1. As a medical student @NHSHighland I was holding the retractors for a surgeon in Oban. To have me change position he swiped at my hands with his scalpel and called me a "stupid cunt". Later he tried to play nice by giving me a chocolate bar, as if that wiped the slate clean.

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Rattled Doc

@rahttled_doc

11 months

3. My English trust had to find locums for the Queens funeral holiday. HR offered locum pay to F1s. They accepted as good money. At 4, on the Friday before, HR then messaged to retract locum rates and told the F1s that they were contractually obliged to turn up. My F1 was crying.

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Rattled Doc

@rahttled_doc

11 months

6. I was told I needed to finish my shift before I took a 4 hour train journey home when my grandma was palliated. I was also told it didn't count as 'compassionate leave' because she wasn't a first degree relative

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Rattled Doc

@rahttled_doc

11 months

12. I had to call my dad at a petrol station because despite me working 80 hour weeks - I didn’t have enough money to fill up my petrol tank.

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Rattled Doc

@rahttled_doc

10 months

Junior doctor thanking Jeremy Hunt and Steve Barclay

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Rattled Doc

@rahttled_doc

11 months

5. I was told that it wasn’t the ‘NHS spirit’ to ask for sick leave when I had an ulnar nerve palsy from a skiing accident and didn’t have the use of my hand. Note that I was required to assist in theatre despite this.

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Rattled Doc

@rahttled_doc

11 months

15. @NHSGrampian - As FY1 on call I was paged multiple times to fix a ward printer. No IT services available at weekends. It was deemed a medical task as discharge letters couldn't be printed.

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Rattled Doc

@rahttled_doc

11 months

7. I was sexually harassed by two orthopaedic consultants at an English trust who were already under investigation for sexual misconduct.

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Rattled Doc

@rahttled_doc

1 month

"Anyone born before the year 2000 seems old to me" - A fucking brave medical student

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Rattled Doc

@rahttled_doc

11 months

9. As a student @NHSTayside I had an ID Consultant verbally abuse me in front of the entire MDT. I spent the next 2 weeks of placement up till 3 in the morning crying and having panic attacks thinking about the end of placement test he was in charge of. It still influences me now

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Rattled Doc

@rahttled_doc

11 months

14. I got told to shave my facial stubble or I should leave the orthopaedic theatre. I chose the latter, and came to Adelaide the following week

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Rattled Doc

@rahttled_doc

11 months

Someone on #MedTwitter mentioned that ex-UK staff might return if #FullPayRestoration is achieved. If NHS toxic culture remains, we won't. If you ever wonder if you'll see our faces again i'd direct you to the words every Aussie knows. "No way. Get fucked. Fuck off"

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Rattled Doc

@rahttled_doc

11 months

4. We were told that if we didn’t show up for work during one of the worst blizzards in 50 years our contracts would be terminated

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Rattled Doc

@rahttled_doc

10 months

And now another 23 UK trained Resident Medical Officers scheduled to arrive from the UK between August and November. Lucky us.

Rattled Doc

@rahttled_doc

11 months

A snapshot of UK doctor numbers in a single department, in a single hospital, in Australia. As of today our ED has : 26 UK trained Resident Medical Officers 23 UK trained Registrars 10 UK trained Consultants Pay your staff what they're worth @SteveBarclay or lose them

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Rattled Doc

@rahttled_doc

11 months

10. I had diagnosed pneumonia and called in sick @BlackpoolHosp . I was told I wasn't allowed to take my leave and if I tried I would be called in for a meeting with management to discuss my sickness.

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Rattled Doc

@rahttled_doc

11 months

11. My (doctor) husband and I were commuting 1.5 hours in separate directions because it wasn’t taken into consideration that we were married.

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Rattled Doc

@rahttled_doc

11 months

I'm very sorry. I've just been advised that my numbers are incorrect. It's actually 13 UK trained Consultants, not 10.

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Rattled Doc

@rahttled_doc

11 months

8. My shit car blew up on the M25 - about 300km away from where we were living. The consultant on call didn't care and told me to charter a plane if thats what it took to get to work.

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Rattled Doc

@rahttled_doc

11 months

So there you have it. Direct and Indirect bullying, Sexism, Attempted Assault, Sexual Harrassment, Uncaring approaches to homelife, Uncaring approach to staff sickness. Every JD here had their story. FPR is only the start of what needs to be done to keep staff in the UK

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Rattled Doc

@rahttled_doc

11 months

27. "To be honest the reason I stayed in Australia is that on my 1st day my consultant said thankyou for my hard work. It really resonated that nobody said thankyou to me in the NHS. After all the hours I stayed late, completed audits, and developed pro formas....nothing"

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Rattled Doc

@rahttled_doc

11 months

13.1 ....and the trust ignored me when I raised safety concerns. I started looking at jobs in Australia around this time. I remember it extremely well. I was seething at management.

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Rattled Doc

@rahttled_doc

7 months

Enough people to cover the entire route in its entirety #walkforyes

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Rattled Doc

@rahttled_doc

11 months

20. @SHSCFT I remember being shouted at down the phone by a Surgical Reg for "wasting her time" when I called worried about a patient who had passed 1 litre of blood from their stoma and looked awful. They subsequently needed massive transfusion and went to ICU

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Rattled Doc

@rahttled_doc

11 months

If you're interested, i've already done a thread on the employment conditions that enticed us to stay in Australia. This however is the experience of 10 UK trained docs (now Aussie EM Registrars) and the NHS culture that drove us away.

Rattled Doc

@rahttled_doc

1 year

Dear @SteveBarclay , There seems to be a lot of interest on UK #MedTwitter ( @RoshanaMN ) in how enticing Australia is for UK docs. Here are a few examples, from a junior doctor who made the move, of the international market you're competing with. You should be worried.🧵

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Rattled Doc

@rahttled_doc

11 months

17. @BlackpoolHosp - Every woman who rotated through Orthopaedics was told by one of the consultants that Ortho isn't a career for women and you need to do GP for the work life balance when you have kids

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Rattled Doc

@rahttled_doc

11 months

19. @NHS_NCLICB 1 month into F1 there's a cardiac arrest post hip replacement. It was chaos as the only doctor for 10 mins. I was shaken up and cried. Rang my Reg for support. Got told "crack on". Zero empathy. Went home and cried. I still remember the patients name to this day

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Rattled Doc

@rahttled_doc

11 months

26. @BlackpoolHosp despite being on the ward round every day for 4 months, and working my arse off, my supervising Breast Endocrine consultant asked "who are you" on my last day when I asked for my end of rotation evaluation. I was a nothing to them.

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Rattled Doc

@rahttled_doc

11 months

13. @ESHTNHS reduced the SHOs from 2 to 1 (with no other doctors overnight) to clerk acute admissions for ENT and Urology, while also managing admitted patients for those specialties plus Orthopedic inpatients. Managing more than one acutely unwell patient became dangerous....

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Rattled Doc

@rahttled_doc

11 months

21. @SHSCFT A surgical consultant who was my "supervisor", but who had never actually met me, wrote my end of rotation evaluation by filling in every mandatory field box with a full stop before writing "average" underneath.

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Rattled Doc

@rahttled_doc

5 months

'Junior' doctors of UK and Irish #Medtwitter . You've had a rough time of it lately in @NHSuk and @HSELive so if you fancy trying somewhere else you should consider coming to the EDs in Adelaide, Sth Aus. They're hiring again for next year so spread the word. Here's what I like🧵

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Rattled Doc

@rahttled_doc

6 months

@AlexNevard @Medic_Russell This is in Australia. I'd have to move back to the NHS. I'd rather just be bathed in urine thanks

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Rattled Doc

@rahttled_doc

11 months

16. @NHSGrampian - One F1 on shift, No SHO. Regs busy elsewhere. 60 bed Ortho dept with multiple sick patients, 1xWeekly Ortho-Geris and incredibly useless consultants….

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Rattled Doc

@rahttled_doc

11 months

Hey @NHSEngland , @NHSScotland , and UK #MedTwitter After my last thread on the NHS experiences of my UK trained colleagues (now Aussie EM Regs) I was sent quite a few DMs by doctors still in the UK who wanted to share their own experiences. This is the promised Part 2 🧵

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Rattled Doc

@rahttled_doc

11 months

18. @NHS_NCLICB on Day 2 as an F1 in Orthopaedics I was asked to do a ward round on 30 patients on my own

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Rattled Doc

@rahttled_doc

11 months

23. @SalfordCO_NHS the ED Consultant lied and said my patient had a respiratory arrest because i'd prescribed an opiate without talking to him in a patient with recurrent calculi, opiate tolerance, and obviously needed it for pain. All just to traumatise me to do things their way

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Rattled Doc

@rahttled_doc

11 months

22. @SalfordCO_NHS the ED Consultant went off at me about preparedness as I misread an obs chart about a fever and said my opinion couldn't be trusted because I had "lied" to them about vitals when I said "I don't think they have a fever but i'd need to double check"

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Rattled Doc

@rahttled_doc

11 months

16.1 …. Anaesthetics run the trauma meeting for some inexplicable reason which usually involves degrading the FY1 about patients they had little to do with

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Rattled Doc

@rahttled_doc

11 months

24. @SalfordCO_NHS the Spinal Reg was abusive down the phone because I made a referral when they had unilaterally decided that it was only a consultant or registrar that could disturb them.

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Rattled Doc

@rahttled_doc

11 months

25. @SalfordCO_NHS when I had closed all my cases in ED and was going to leave on time I was expected to take another case despite already working 7 days in a row and being hours late every day

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Rattled Doc

@rahttled_doc

11 months

If the owners of the anecdotes have consented i've tagged the relevant trust so they can consider their own trust culture. We're not alone in UK #MedTwitter in our experiences (as @Xeon4f145d96s1 posts show) but here's just a sampling of why it was so shit in the NHS

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Rattled Doc

@rahttled_doc

10 months

I'm nourished by the raging in the UK Daily Mail comments section. Deeeeeeelicious

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Rattled Doc

@rahttled_doc

11 months

One important thing left off my most recent thread. I want to thank the EM Registrars involved for sharing these anecdotes with me. Having added some of my own I know how it can drag up bad memories that we often would rather forget. Youre all amazing doctors and colleagues.

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Rattled Doc

@rahttled_doc

2 months

First picked up by one of our new UK EM STs. Thanks again @VictoriaAtkins

Chris Picton MP

@PictonChris

2 months

Thank you to the amazing doctors and nurses of the @RoyalAdelHosp ED night shift who helped 16 people with carbon monoxide poisoning presenting in the early hours of this morning. Anyone with symptoms should see a doctor; pregnant women and very young infants without symptoms.

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Rattled Doc

@rahttled_doc

11 months

And in the interest of giving options to those in need. Come play in Adelaide if you're sick of the same shit. My main bullying complaint here is that @KitkatRom won't let me have a department dog

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Rattled Doc

@rahttled_doc

4 months

A phone call from a rural GP simultaneously managing a snake envenomation and delivering a baby is my regular reminder that I will never be that cool

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Rattled Doc

@rahttled_doc

11 months

@DrJonathanD @NHSEngland @NHSScotland I disagree with 2. The caring staff are out there and by demonstrating that you can be a good supportive person towards colleagues and juniors you can show them a better way and improve the culture over time. Raising people's consciousness that it hasn't gone away has purpose

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Rattled Doc

@rahttled_doc

11 months

@EM_VATA @NHSEngland @NHSScotland @RCollEM I don't think this is the flex you think it is.

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Rattled Doc

@rahttled_doc

6 months

People defending this aspect of the approach to pay in the NHS are ridiculous. My pay in Australia is calculated at 15minute increments and there's absolutely no contractual requirement for anyone to work unpaid time because of payroll incompetence. Total NHS learned helplessness

Eilidh 🦀

@DrEilidhMaria

6 months

Is there something wrong with doctors in the UK? How are people possibly arguing I do 150 hours of unpaid work? It amounts to at least £3000? I’m so beyond angry, demoralised, and feel so undervalued in a very personal way. Watching colleagues defend this is even worse.

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Rattled Doc

@rahttled_doc

9 months

Not even 2 months old and they've already got 607 doctors in the group looking for a way out of the UK.

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Rattled Doc

@rahttled_doc

11 months

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Rattled Doc

@rahttled_doc

3 months

Three out of five new EM Consultants starting this year in @CentralAdlLHN are UK graduates who were persuaded to leave by @Jeremy_Hunt . I wonder how many will come through training here in the future thanks to @SteveBarclay and @VictoriaAtkins

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Rattled Doc

@rahttled_doc

1 year

@barnjob12 @GuylArnel @SteveBarclay @RoshanaMN Private insurance is NOT a requirement.

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Rattled Doc

@rahttled_doc

9 months

To all the UK doctors moving to Australia : Make sure to join your local union when you arrive and don't lose the fighting spirit you've developed in the UK. You can benefit Australia with that just as much as with your medical skills.

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Rattled Doc

@rahttled_doc

6 months

@OrthopodReg I dunno. A long time ago a friend (who became a special army soldier) gave me some exam advice too. The ACEM examiners were a bit shocked when I emerged slowly from the water covered in camo paint and started lobbing grenades but ultimately I passed so...

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Rattled Doc

@rahttled_doc

9 months

"No the new doctors in [surgical dept] don't put down their overtime because it's their fault they're there late because they've not learnt how to be faster in the department yet" No. Fuck that. If you're working late you should be paid for it. Explicitly tell your staff that.

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Rattled Doc

@rahttled_doc

11 months

@AlbertSmeee @DevanSinha @SteveBarclay Taxes. It comes from taxes.

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Rattled Doc

@rahttled_doc

7 months

Nice day for a walk #walkforyes

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Rattled Doc

@rahttled_doc

1 month

Wonder if anyone has been honest enough to use this diagnosis code

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Rattled Doc

@rahttled_doc

11 months

I've had quite a few DMs with experiences equally, if not more, horrendous for students and junior doctors in the NHS. If people want I can post a 'Part 2' of sorts with those DMs that give me explicit consent to do so. If you're interested feel free to DM me

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Rattled Doc

@rahttled_doc

3 months

Anyone got any top tips for someone starting their first EM Consultant job next Monday? I've already got "don't be a handover wanker" and "don't get sucked into seeing patients rather than keeping oversight"

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Rattled Doc

@rahttled_doc

11 months

As a reminder, if anyone reading thinks they may have recognised someone from the anecdote given....no you fucking didn't.

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Rattled Doc

@rahttled_doc

11 months

1. @EastCheshireNHS on my first ever day as an F1 I was left alone on a ward of 30 patients with no SHO, registrar or consultant support. I left late and exception reported to be told by the consultant that it was my problem and I needed to manage my time better

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Rattled Doc

@rahttled_doc

6 months

@rebecca_rigney Im picturing someone with the combined skill set of Indiana Jones swapping the Idol and one of those table cloth pulling magicians

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Rattled Doc

@rahttled_doc

5 months

3. You're paid for every hour you work No crazy situations like @DrEilidhMaria experienced where you're told "it'll all average out in the end". If you work the hours you get paid the hours (in 15 minute increments). No arguments. You're paid.

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Rattled Doc

@rahttled_doc

25 days

"Oh yeah the patient was accepted by our team for transfer to the hospital but if you could just fully examine them, send the bloods, order the imaging, and call this other team to consult before we take them from ED that would be great"

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Rattled Doc

@rahttled_doc

11 months

Am I Ever Gonna See Your Face Again : The Angels Live Melbourne 1988

The time: 1988. The place: Royal Melbourne Showgrounds. The event: The Melbourne Music Show - Under The Southern Cross. The inaugural Melbourne Music Show wa...

www.youtube.com

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Rattled Doc

@rahttled_doc

4 months

It used to only really be FY3s that came over to jobs in Adelaide EDs but increasingly we're getting Anaesthetic and EM Specialty Trainees moving over at mid-ST level. I can only hope you continue a long Tory Health Minister tradition to keep progressing that @VictoriaAtkins

Victoria Atkins

@VictoriaAtkins

4 months

My statement on the BMA junior doctors committee’s decision to walk away from negotiations. My message to the committee is clear: call off the strikes and come back to the table.

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Rattled Doc

@rahttled_doc

11 months

15. At a MET call as an F1 I got a needle stick from a high risk patient. Called the lab to see what bloods they needed from me. Was told that we aren't going to pay for your bloods to be sent to Newcastle for testing and "if you've got HIV now there's nothing you can do anyway"

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Rattled Doc

@rahttled_doc

11 months

10. @NHSNLaG asked me to have a sickness review meeting after I went off sick more than 3 times that year. The meeting was spent explaining that frequently working up to 68hrs/week and having an unmanageable workload is a recipe for frequent sickness. Nothing came of that meeting

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Rattled Doc

@rahttled_doc

11 months

I didn't expect to have to add the exciting point of "Employer supplied pens (the good kind), pencils, batteries, rubber bands, etc" to my thread on reasons I stayed in Australia rather than the NHS

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Rattled Doc

@rahttled_doc

11 months

@Dr_Done_ @NHSEngland @NHSScotland @amateuradam Ha! I got enough semi PTSD from just watching "This is going to hurt"

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Rattled Doc

@rahttled_doc

11 months

12.1. Told deanery at ARCP that I would rather quit training than go back to a practice which used its trainees to do their private work while they had lunch in a nice restaurant most days. I now make damn sure our own GP trainees are very well looked after and supported.

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Rattled Doc

@rahttled_doc

6 months

A good role model for all EM Physicians. I mean in more of a "don't be like this guy" way but still.

Dr Shaun Favell

@DrFavell

6 months

@DrEilidhMaria Perhaps you should reflect on your time management skills?

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Rattled Doc

@rahttled_doc

11 months

4.1. No pre warning or discussion. Utterly heartbreaking and soul destroying to have multiple staff turn toward me mid M&M and judge the actions of an FY1 who was covering all wards in the hospital overnight.

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Rattled Doc

@rahttled_doc

11 months

5. @ELHT_NHS I was repeatedly told, by senior members of staff, to go back to where I came from. I left to work for a private organisation instead. Best thing I ever did.

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Rattled Doc

@rahttled_doc

11 days

I knew I wanted to do EM training but the EM I experienced in the UK had me working more as a triage service, giving up all my opportunities to actually provide thorough care, and was rife with shitty culture from the Consultants. The money and lifestyle in Aus were a 🍒 on top

Thomas Shanahan (Dr.) MRCEM

@clifford0584

12 days

For those from 🇬🇧 and 🇮🇪 and other places why did you move to Australia to work as a doctor? #NHS

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Rattled Doc

@rahttled_doc

11 months

And for those I haven't replied to yet please know its only because it's been night time here and I want to give my response the attention you deserve

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Rattled Doc

@rahttled_doc

11 months

I've had quite a few DMs with experiences equally, if not more, horrendous forstudents and junior doctors in the NHS. If people want I can post a 'Part 2' of sorts with those DMs that give me explicit consent to do so. If you're interested feel free to DM me.

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Rattled Doc

@rahttled_doc

6 months

@ReddicalMedge

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Rattled Doc

@rahttled_doc

4 months

It turns out the level at which I'm fully on board with staff wellbeing initiatives is when the initiative is a free food truck festival for staff @RoyalAdelHosp . Delicious!

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