SH @stephenrhughes Twitter profile

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@PrestonMcMurry

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@stephenrhughes

4 months

@ShaunLintern Shaun, I had a full career in both academia and industry before medicine. I like to think of someone at my previous company being offered a job then starting on the first day and being told: - You can't park - You have no desk - You have no chair - You have no IT logon 1/n

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@stephenrhughes

4 months

@ShaunLintern - drinking the tea is STEALING - your professional qualifications are mandatory but you need to pay for them yourselves - no you can't have the day off to do your professional exam

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@stephenrhughes

4 months

@ShaunLintern - You'll work an extra 1.5 days per week compared to everyone else for the same pay - We may not pay you on time - Your working hours will change every 4 months but we can't tell you when - you'll change jobs every 4 months and be expected to ace it from day 1

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@stephenrhughes

3 months

@marinadpol I'd love to see most hospital consultants attempt a day as a GP. They'd be humbled.

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@stephenrhughes

5 months

@BucksHealthcare @Xeon4f145d96s1 @NMacdonaldBHT @AndrewMcLBHT So am IMT3, who will probably have MRCP and can act as med reg is paid the same as a PA? You must know that makes no sense whatsoever?

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@stephenrhughes

2 months

@gmcuk You could have very easily had a second, entirely separate register. It's 2024. This would have made it much clearer for patients but you chose not to. What are the reasons you chose not to have a second register?

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@stephenrhughes

5 months

@DyfrigH Alright...I'll "wade in" here too. Put yourself in the shoes of a medical student, F1, F2 or CT, their training degraded year on year whilst other professionals are paid more, treated better, given more opportunities and all while working fewer hours. How would you feel?

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@stephenrhughes

4 months

@Dr_Done_ This is harrowing. This is horrendous. This is unforgivable. This is the future of healthcare in the UK if we don't do something to stop it.

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@stephenrhughes

2 months

@NathanTrout TIL medical school and postgraduate medical training is "coasting". Also, you'll find doctors coming from increasingly diverse backgrounds. This isn't the 1950s.

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@stephenrhughes

3 months

@DrEilidhMaria Eilidh, you have genuinely uncovered what I think is a scandal and should be on national news. You are doing amazing work. Don't let your detractors and those with vested interests stop you.

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@stephenrhughes

7 months

@RCSEd Imagine being a core trainee or F2 or F1 keen on surgery and seeing this at your Trust.

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@stephenrhughes

4 months

@doctor_dru_ "make sure you do that gent level, it's due at 10am"

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@stephenrhughes

5 months

@ShayanAshjaei @RobLaurensonD4P As someone who is soon to be registered by the GMC, you should realise that making veiled threats of a vexatious GMC referral is itself against GMC guidelines.

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@stephenrhughes

4 months

@DrEilidhMaria More accessible.....except between 17:01 and 08:59 and on weekends and bank holidays. Also, as if we choose to move around every 4 months.

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@stephenrhughes

1 month

Very pleased that I have been offered (via upgrade) my first choice place for Core Psychiatry training in West Yorkshire. I am not being faux humble when I say that I do genuinely think I got "lucky" and the fact I've had to rely on luck really upsets me.

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@stephenrhughes

4 months

@OcoRory A very reasonable opinion Rory. Ideally I'd like to see Consultant reserved for doctors only but if other professionals are to use it then we need to be very clear for the sake of colleagues and patients.

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@stephenrhughes

4 months

@gmcuk @TheDA_UK Simple, don't regulate them as they are not doctors. HCPC is the best regulator for allied health professionals. Your prior consultation was insufficiently advertised with a poor response rate and, as such, was flawed.

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@stephenrhughes

4 months

Ladies and gentlemen, the future of primary care in the UK. Overseen and encouraged by the very medical leaders we previously put our trust in.

Dr Done

@Dr_Done_

4 months

FAO GPs in the UK❗️ Unfortunately you’re no longer required due to ‘new ways of working’. Don’t worry though, nobody is replacing doctors, and if you’re against MAPs - you’re a bully.

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@stephenrhughes

4 months

@emmdechen Please don't infantalise doctors by labelling them as "undergrads". I have BSc, MSc, PhD and a medical degree so I speak with some authority that demeaning a medical degree as just an undergraduate degree is ridiculous and shows a complete lack of insight into medical training.

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@stephenrhughes

3 months

@deborahgoshko @DrEilidhMaria If this is true then I am gobsmacked you think this is OK.

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@stephenrhughes

2 months

@TheBMA This is a great start. Well done BMA standing up for doctors AND for patients.

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@stephenrhughes

2 months

@DrKateSimpson_ I worked on a ward where there was no doctors office but they were refurbing a room on the ward. New doctors office? Nope place to store dead COWS and equipment trolleys.

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@stephenrhughes

3 months

@manLikeTeaa @Dr_Done_ @Xeon4f145d96s1 They're not even pretending now. ST3 has 5 years post grad experience plus a medical degree. Prob has some or all of MRCPCH. PA has none of this. Parents at this Trust need to know who might be assessing their kids.

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@stephenrhughes

8 months

@mmamas1973 Public inquiry needed. Senior management and Trust Executives who effectively enabled this should be bought to account.

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@stephenrhughes

3 months

@r1chardf1tzg3r1 @BritRenalSoc @ERAkidney @NHSEnglandNMD @RBNHSFT @TheBMA @doctor_oxford @TheLancet @TheLawyermag @LBC Would be a great opportunity for a Trust Grade position for an actual DOCTOR interested in renal medicine. But nah, just sell your junior medical colleagues out and get a more expensive, less knowledgeable PA to do the job

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@stephenrhughes

5 months

@ExplosiveEnema @BWC_NHS @FPARCP That reads like the job plan of a consultant or registrar in that quaternary specialty. Yet, the person doing this was nowhere near having that level of knowledge or experience. Utterly terrifying.

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@stephenrhughes

4 months

@Dr_Done_ PSA considerably tougher than this and it was probably the easiest exam I sat at med school.

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@stephenrhughes

24 days

@Drmehaktahir "must not attempt to interpret ECGs independently" As an F1, I used to print the ECG then close my eyes and stumble blindly around the hospital until I bumped into the cardio reg. I once opened my eyes and accidentally almost saw a left axis deviation. Oh the shame.

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@stephenrhughes

7 months

@nicalexander1 @Dr_Done_ @ImperialNHS I'm not anonymous. You didn't answer the questions. If I was F1 or F2 in your team for 4 months, how much guaranteed clinic time, theatre time and teaching time would I get?

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@stephenrhughes

7 months

@nigelpenfold @jeannie_watkins This has to be satire surely.

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@stephenrhughes

2 months

Come on now. This is not just a few privileged "cranks" on Twitter with a chip on their shoulder. These are actual real life cases of gross mismanagement resulting in a patient's death reported in mainstream media. This dangerous experiment needs to be paused.

Dr Matt Kneale

@drmattuk

2 months

Family of film make-up artist call for inquest after treatment by physician associate which led to death. @JanetEastham @TheDA_UK @TheBMA

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@stephenrhughes

2 months

@AbbieTBee That's great and I'm happy for you. I was lucky to get my first choice through pre allocation and points but let's not pretend the current system is fair. It is dehumanising and treats our new F1 doctors like numbers.

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@stephenrhughes

2 months

@SecretPhysician Impression: Not got a flipping clue Plan (as discussed with PAAUK chums): Get a doctor Farcical, terrifying and unfortunately unsurprising.

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@stephenrhughes

1 year

@RCoANews Why don't you get serious about advocating for your own anaesthetics trainees who your pay membership fees.

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@stephenrhughes

4 months

@isitsleepytime I worked for a consultancy before. The "product" that a consultancy sells is the expertise of their staff so they generally treat them well and encourage them to develop. The NHS is nothing without clinical staff yet we are all treated terribly. It just doesn't make sense.

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@stephenrhughes

2 months

@DrSeanMon Yeah I was surprised and skeptical of those numbers mentioned. I did a PhD before med school. I have a total of 3 papers from it and it took me years. Tens of publications during med school suggests not the most rigorous of research or just padding of author lists for mates.

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@stephenrhughes

1 year

@DocsDoItBetter @walsh_joe I am just going to go out on a crazy limb here and say that a SENIOR member of medical staffing should know within much less than 26 days if one of their members of staff has died. It's just unacceptable and they should be ashamed.

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@stephenrhughes

4 months

@DrPastry @MedReddit You'll always have a job......blah....blah....blah.... There's plenty of work to go around....blah.......blah.......blah....... Say the twilight of their career consultants on their substantive contracts.

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@stephenrhughes

7 months

@Dr_Done_ To be honest, I'm impressed by these PAs and their incessant drive to lobby and expand their scope. They are acheiving exactly what they want to. And it is juniors and patients that are being left behind.

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@stephenrhughes

4 months

@LBC @NickFerrariLBC PAs are categorically replacing doctors in across the NHS and there are numerous documented examples of them working essentially unsupervised and way beyond their original intended scope. This is a dangerous experiment and NHS patients are the test subjects.

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@stephenrhughes

3 months

@UMAPsUK How many times do I have to say it, the "initial education" of a PA is irrelevant because it is not guaranteed to be anything related to medicine and doesn't necessarily even need to be science. Therefore, their only guaranteed "medical training is 2 years.

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@stephenrhughes

3 months

@thatsnotmine125 The "initial education" that is guaranteed to be relevant to healthcare is just 2 years though. Lots of examples of PA courses taking non "life sciences" undergrad courses.

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@stephenrhughes

4 months

@IncogAssociate @Dr_Done_ Why is this so difficult to understand? If we are going to make fundamental changes to the way we deliver healthcare, the onus should be to provide ROBUST evidence that this new way is at least as safe and cost effective as the current way.

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@stephenrhughes

5 months

@RotherhamNHS_FT I don't know what this practioner (who I've no doubt is great) actually does. Are they doing the scans or are they seeing/assessing/diagnosing patients. If it's the latter then that is extremely worrying.

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@stephenrhughes

3 months

@DrEilidhMaria @chriscpritchard Can't wait to see the usual parade of PAs and their apologist retired consultants blame this on doctors somehow. I say we gun for the radiology reg who should manually check the CV and credentials of every person who requests a CXR

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@stephenrhughes

4 months

@Dr_Done_ To be honest, that first clips comes across well. She seems passionate about what she does and has a good reason for choosing the route she did. Its just, medical graduates should have the same option to specialise earlier and not be flung around the country too.

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@stephenrhughes

4 months

@ClareGerada @Dr_BellaR Easy to say when you've already had your "next 20 years". Open your eyes to the reality of junior doctor training and opportunities. You are supposed to be a leader so act like one.

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@stephenrhughes

8 months

@RCOphth Just.....train....more....... ophthalmologists.

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@stephenrhughes

4 months

@doctor_dru_ Urology and gent. A tale as old as time.

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@stephenrhughes

9 months

@NHypService @veggieequallife I'm F1. My jobs list can encompass multiple tasks that require privacy and concentration. Distractions cause mistakes that could be significant. E.g. constant interruptions when prescribing. I discuss confidential patient matters with my colleagues and other specialties 1/

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@stephenrhughes

9 months

@NHypService @veggieequallife I make sensitive phone calls to families about matters including DNACPR, end of life care and even to tell them their loved ones have passed away. Without a doctor's office I'm forced to do the above in the corridor or at the open nurses station 2/

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@stephenrhughes

4 months

@ellorakamineni Ladder pullers gonna ladder pull

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@stephenrhughes

2 months

@caroll_ste87889 A series of accidents: - accidentally log into prescribing system - accidentally enter patient name - accidentally type medication name - accidentally choose dose - accidentally choose timing and duration - accidentally click allergies/warnings - accidentally press 'confirm'

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@stephenrhughes

2 months

@DrEilidhMaria @RCPhysicians But remember....it's us doctors that are the arrogant ones right? God, that article is an absolute mess, patronising and riddled with falsehoods.

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@stephenrhughes

4 months

@Brozapine Trained in the driving model.

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@stephenrhughes

8 months

@BMAScotland @DrIainKennedy This is amazing, well done @BMASco

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@stephenrhughes

4 months

@Adam_Skeen Wade into a debate with a pointless #holyMDT gesture, proverbially sticking two fingers up to your junior medical colleagues at the same time and then shutting down your comments. All while clumsily complaining about not being able to make a nuanced point. Sounds about right.

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@stephenrhughes

3 months

@LeanneHPatrick The original tweet from the department had replies locked with only consultants working in the department able to post positive replies. And the vice president of the UK PA Faculty works in the same department. And you talk about propaganda....

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@stephenrhughes

5 months

@doctorhelgi @Moham1287 Alright, I'll bite as a non-anonymous doctor sharing many of the concern of the anon accounts. As a senior clinician at this symposium, what is YOUR actual constructive contribution to this debate? So far all you've done is snipe at people on Twitter.

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@stephenrhughes

4 months

@emmdechen You are clearly unable or unwilling to discuss this in good faith so I'm not going to engage further.

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@stephenrhughes

3 months

@danny_mercer Same, it is demoralising, destabilising and makes planning anything more than 3 months in advance virtually impossible.

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@stephenrhughes

5 months

@Dr_Done_ Seeing patients in resus with max 1 year experience on top of an unregulated, unstandardised 2 year masters. No one can possibly justify this.

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@stephenrhughes

3 months

@LeanneHPatrick Junior doctors, forced to change jobs every few months, forced to move all over the country, forced to do countless hours of self study in their own time and pay for the pleasure, forced to suck up being infantalised, belittled and bullied by senior colleagues......

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@stephenrhughes

2 months

The irony of wheeling this microbiological cornucopia around various wards to raise awareness about a condition arising from an infection.

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@stephenrhughes

4 months

@IncogAssociate @timricketts_ @OcoRory @mouseter_chef @Xeon4f145d96s1 @DrEilidhMaria @Dr_BellaR @RobLaurensonD4P @RobJimFleming @Dr_Done_ As a collective you're not making it easier though? Taking limited training opportunities from doctors whilst being paid more for less hours and less responsibility?

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@stephenrhughes

2 months

@hannahmillana Remember, you are not a human with a life. You are a magenta colour coded row on an Excel rota spreadsheet.

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@stephenrhughes

5 months

@DyfrigH I'd be willing to bet you didn't have such concerns when you were a junior 25 years ago. Targeting individuals is wrong, of course. Raising our sincerely held and legitimate concerns about our careers and patient safety is not. And I'm not anonymous.

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@stephenrhughes

4 months

@Parody_RCGP As far as I can see, it only make sense via ARRS and then having a liberal approach to supervision. Once ARRS comes to an end, hopefully the true farce underlying this whole scheme will come to light.

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@stephenrhughes

3 months

@GMCharlatan "do not meddle in the affairs of PAs, for they are subtle and quick to anger"

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@stephenrhughes

10 months

@RoshanaMN That F1 might look a bit out of their depth that first time they deal with a GI bleed or stroke or hypo or seizure or whatever. But they will deal with it, seek senior support and you can bet the second time they see the same thing, they absolutely smash it

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@stephenrhughes

4 months

@lymi66 @drcolinm @HealthRegLawyer The irony of a dependent practitioner who lets the F1 do all the risky stuff for them calling doctors "sheltered".

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@stephenrhughes

3 months

@AlexJDeighton Yeah but we're all loaded on six figures and come from well off backgrounds so we can afford it? And we can always locum right? Cos that's easy on top of a 48hr week.

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@stephenrhughes

4 months

@dr_shibley Where did anyone, in this entire debacle, say that? Please don't be so reductionist.

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@stephenrhughes

5 months

@TVRJDC @BucksHealthcare @Xeon4f145d96s1 @NMacdonaldBHT @AndrewMcLBHT Awesome work calling out their bullshit.

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@stephenrhughes

3 months

@Roddy_Neilson @OGdukeneurosurg And never any bad blood between you? I'll see myself out.

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@stephenrhughes

3 months

@mjv__1 Best I've done in F1/F2 so far is a joint aspiration under supervision of a kind reg. Otherwise just the same venepuncture, cannulas, NGs, catheters and TTOs. Worked on a AAU where most drains/LPs etc done by the PAs in hours.

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@stephenrhughes

24 days

@benollivere @DrANChekroud @BoneJoint360 "please help me take this conversation offline so I can avoid awkward truths that I either ignored or was blissfully unaware of"

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@stephenrhughes

7 months

@Dr_Done_ @SheffieldHosp @MajorKirsten1 Ugh....this is Sheffield. My dad will be having an elective GA here at some point soon. I will be advocating for an actual doctor to be providing that, not this Captain joker

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@stephenrhughes

18 days

@cannula_service Some of the disingenuous pro PA lot are so fond of telling us how small the PA/AA workforce is c.f. doctors. Yet these seem strangely over represented at these high level groups involved with shaping future healthcare delivery. Weird that.

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@stephenrhughes

5 months

@HelenRSalisbury @GMC At the moment, all this registration will achieve is a sense of false equivalence and an illusion of regulated practice but without actually addressing the real and vital concerns around scope, regulation, supervision and patient safety.

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@stephenrhughes

10 months

@elinlowri @gaslad 2/2 My training has consisted almost entirely of ward round then jobs. PAs where I work often have weekly clinics, procedure lists and regular time off the wards for study. I'm happy to not be anonymous and state that I think this is a problem and is detrimental to training.

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@stephenrhughes

3 months

@xxsnzz It must be nice for you to live in such a simple, black and white world. I've never given my logins to anyone but your post is embarrassingly naïve to the many and varied pressures on staff in the NHS. Often those most pressured are conveniently the most junior.

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@stephenrhughes

5 months

@actor_joshua @wendyburn @DrEilidhMaria @Xeon4f145d96s1 @Dr_Done_ Awful. The lack of awareness from both the PA and, even worse, the consultant is ridiculous.

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@stephenrhughes

4 months

@DrHoenderkamp @_Doctor_Dom I suggest you do some maths homework then.

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@stephenrhughes

3 months

@DrPastry I read this in a Boston accent.

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@stephenrhughes

4 months

@4NaanJeremy Strong 'iamverysmart' vibes coupled with a huge chip on the shoulder. Almost feel sorry for them.

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@stephenrhughes

8 months

@wendythedentist @bykatewomersley It's a sad state of affairs when medical doctors aren't allowed to put Dr on their badge cos it's confusing patients.

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@stephenrhughes

23 days

@MariaNagy899529 @iDrSunny @DrANChekroud Imagine not wanting working conditions to improve for your future and current colleagues.

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@stephenrhughes

4 months

@IncogAssociate @D__Melb @timricketts_ @OcoRory @mouseter_chef @Xeon4f145d96s1 @DrEilidhMaria @Dr_BellaR @RobLaurensonD4P @RobJimFleming @Dr_Done_ Burden of proof should be on the PA lobby to provide the evidence that PAs provide safe and cost effective care in comparison to doctors. So far I have seen very little in the way of actual evidence for the above. So I will remain intensely sceptical.

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@stephenrhughes

3 months

@IncogAssociate @Burnt2020 @TheBMA Imagine putting your ego and the perceived status of your profession gained vicariously through a false equivalence to doctors above an appropriate regulatory framework.

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@stephenrhughes

4 months

@EmieMoose We did pharmacology literally from week 1 of med school. Pharmacology tested in every MCQ and OSCE we and had specific OSCE prescribing assessments in later years. There's also a little thing called the PSA. Person in this video is at best ignorant and at worst a liar.

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@stephenrhughes

3 months

@Annie168918 @DrTweXet @ExMomentum_NHS Cos they get all the opportunities to do those procedures whilst doctors stuck doing admin work.

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@stephenrhughes

7 months

@mouseter_chef @AoAA_uk The ridiculous double standards of "respect the MDT" laid bare.

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@stephenrhughes

3 months

@SaraTon08500527 A union using it's well established internal democratic processes to achieve change in policy to better further the interests of it's members. Utterly shocking state of affairs I know. Or will you take any opportunity to dump on doctors?

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@stephenrhughes

3 months

@thatsnotmine125 @Xeon4f145d96s1 The GMC MPTS website is littered with initially vexatious or untrue complaints and then the GMC went fishing for further dirt dragging innocent doctors through years of unjust process, uncertainty and financial hardship. Many commit suicide or face financial ruin

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@stephenrhughes

2 months

@caroll_ste87889 @Dr_Done_ I have 12 years of higher education up to and including a PhD. Do you know how much of that I count as medical training? Just the 4 year medical degree. Let's stop lumping in previous degrees into the PAs "experience". It's misleading.

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@stephenrhughes

6 months

@autumnleaves046 @Dr_Done_ @danny_mercer I have a PhD in another subject prior to getting my medical degree. I certainly didn't go around introducing myself to patients as Dr Hughes whilst I was a medical student. That would have been unprofessional and misleading.

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@stephenrhughes

6 months

@DrNeilStone Imagine being a junior doctor working harder than ever in a stressed system for increasingly less real terms pay whilst an untrusted profession cherry picks all your training opportunities and gets paid more whilst working a fraction of your hours.

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@stephenrhughes

3 months

@pulsetoday "different ways of working". Yeah, slower, less safe and more expensive.

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@stephenrhughes

4 months

@jabberwock951 I'm 39 and a F2. Next 10 years is a significant chunk of my career. Pay me decently now please.

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