James @jprgooch Twitter profile

Last Seen Profiles

@PSTamangGolay

@FitzyLeakz

@skywalker_arts

@Ahmad_Azeem_

@h0dori

@meanimefemboy

@boulton_pe47768

@yama_to0828

@CATT0BIN

@blasterceo

@Ansionista

@JayDanielsMVP

@CarolineCoramUK

@oez_dilek

@xX760Xx

@love_pokeLiella

@andrikpayne

@sglheritage

@rad_comrade

@Tabrakadabra

@DdeonuMichelle

@FENIXNEMO

@OfficialRFDTV

@somkanel

@deborahcarati

@internetsehat

@fvcking_boss

@bts_nanak_

@PlastererMatt

@DearAnob

@Bimen5678

@livices

@onaranlarkulubu

@bbCupidReading

@simmy

@amikelap

James

@jprgooch

2 years

Really struggling to stay in medicine if I’m honest. Very close to just walking away.

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James

@jprgooch

3 years

A retiring consultant told me as a CT that there are 3 golden rules to anaesthetics: 1) Don’t be pressured in to skipping lunch. 2) Don’t overtake anyone on your car ride home after nights. 3) Don’t run to arrests. I’ll add: 4) Don’t base your self worth on passing exams.

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James

@jprgooch

1 year

@drkeithsiau Crayolaparotomy.

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James

@jprgooch

2 months

Well this is extremely depressing.

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James

@jprgooch

3 years

I bet the FYs and SHOs who worked hardest during the pandemic to provide the best patient care are currently scoring worst on CST applications. It’s bad for doctors. It’s ultimately bad for patients. It’s just wrong - and it will worsen morale and retention.

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James

@jprgooch

3 years

My hospital has started a “back to better” campaign and announced today “we are here to hear”. This is a direct quote from ‘The thick of it’ and I am now in a satire.

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James

@jprgooch

4 months

When I was an FY1, a retiring acute oncologist listened to me defend a protocol and then told me: “doctors are not paid to follow protocols - we are paid because we know how to break the rules.” A lesson I’ve remembered ever since!

Balazs

@cannula_service

4 months

"PAs sit perfectly here as qualified enough to follow the algorithm but not qualified enough to see when it should be overruled." Very well put.

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@jprgooch

3 years

Hi @sajidjavid - this is why the NHS is falling apart. You have literally hundreds if not thousands of doctors who are unable to get jobs…during a staffing crisis. We need more doctors in every speciality. Fund HEE urgently!

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James

@jprgooch

3 years

For me the biggest kick in the teeth last year was that lots of people who didn’t actually do any of the ITU care of covid patients got their names on papers and then got jobs while those of us too busy to do so because of *patient care* got left on the scrap heap. #losttribe

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James

@jprgooch

1 year

I am so, so thankful I left the NHS. My life is so much fuller and happier. My relationships are better, I am being invested in by my employer. Oh, and I earn more money. It helps.

Saul Staniforth

@SaulStaniforth

1 year

Interviewer: "Retention is the key word here, isn't it? Surely if you pay staff... what they deserve, then that will help with retention. That's not part of the plan, is it?" The National Medical Director of NHS England: "No, its not part of the plan"

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James

@jprgooch

1 year

If the private sector starts offering CESR programmes the NHS is utterly, utterly f*cked.

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James

@jprgooch

4 months

This is madness. I work in the private sector and manage a private ITU. I can confidently say there is absolutely no way we would ever get away with this absolute dereliction of duty in maintaining standards and safe staffing. What is happening in the NHS?

Janet Eastham

@JanetEastham

4 months

Whistleblowers claim that any substitution of doctors is a risk to patient safety, especially out of hours. The roster for the Hospital of St Cross in Rugby reveals that today the “on-call cover anaesthetist” shift is being filled not by an anaesthetic doctor, but by an

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James

@jprgooch

4 months

The @gmcuk apparently have no say on scope of doctors so I think I’ll have a crack at doing some TAVIs next week. Looks fun! PAs have done these and GMC were fine with it so I guess I can just ask for some kind of non standardised training and get going, right?

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James

@jprgooch

3 years

My non medical partner made an interesting observation about the repeated anaesthetic debacles; “Sure, they’re making honest mistakes. But that just shows you that they don’t even think you are worth double checking their work before they hit send.”

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@jprgooch

3 years

I’ve not done a night shift for 2 months now and I can’t tell you how well I feel. I haven’t felt this good for years. There should probably be a conversation about the consequences of long term nights. I didn’t realise how ill I was until I stopped.

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@jprgooch

1 year

For the first time since becoming a doctor I can honestly say that I am truly happy. I have a job I’m really enjoying, a house in London with my amazing partner and I’m currently on a beach in Mexico at the fantastic @Royal_Hideaway having the best time. (The Margs are 👌!)

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@jprgooch

1 year

I asked for an exit interview when I left training. Denied by HEE.

Neena Jha

@DrNeenaJha

1 year

I’ve never understood why the NHS doesn’t offer exit interviews to those who leave… In what other workplace do you have employees leaving in droves, yet continue to ignore it & refuse to try to understand why, so you can prevent it collapsing?! It’s unbelievable 😡

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James

@jprgooch

2 years

The issue is, if you keep stopping people with 3,4,5+ years of anaesthetics getting ST jobs we outgrow them both in salary and competence. I now can’t realistically re-enter training because it would be a huge pay cut in a cost of living crisis. Also, it looks utter shit.

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@jprgooch

11 months

I think people need to go and watch “Bodies”. It’s on iplayer. Best depiction of NHS whistleblowing I’ve seen. Also, just because no one else in society takes responsibility for stuff anymore doesn’t mean that doctors are blame sponges because they still do.

Shaun Lintern

@ShaunLintern

11 months

A lot of people asking why the drs never went outside the trust. Not to the police, media, other agencies. It is a legitimate question....but our report shows the culture of the org didn't really encourage this. How true is this of other NHS trusts? #lucyletby

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James

@jprgooch

11 months

Should MPs also have to be “kind”? Imagine if a doctor said this to someone. We should hold our MPs to some basic standards of public life.

platinumpizza™

@Xeon4f145d96s1

11 months

This is MP @PhilipDaviesUK . Much like the rest of the Tory party, he hates doctors. However, it seems he hates them even more than his other crony friends. The tweet below is a reply he sent to a doctor who sent him the BMA letter asking him to support the strikes.

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James

@jprgooch

2 years

@morefluids Was reprimanded for wearing colourful socks by a matron and told to read “the sock policy”. It sadly did exist. To this day I now deliberately wear hideously colourful patterned socks.

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James

@jprgooch

1 year

Big increase in applications this week to come work with us in the private sector from impressive doctors caught out by training bottlenecks who’ve had enough. We’ll look after them but the NHS is losing their greatest resource at an increasingly rapid rate.

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@jprgooch

1 year

Every Monday I take 5 minutes to absolutely seethe about the state of medical education in the UK and hate on HEE. Then I get on with my week.

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@jprgooch

1 year

It’s a great step but what happened to just a bloody bed with some pillows? I could never sleep in these types of chairs and they’re much more expensive while seemingly taking up more space than a single bed.

Salman Naeem

@salmannaeem217

1 year

Excited to try out the latest rest facilities we manged to arrange for #juniordoctors @EKHUFT . Sleeping pods for all sites & massage chair for ED. Kudos to the whole team @The_LondonERs @EKHUFTUEC @EMTAcommittee @RCollEM @TheBMA #healthandwellness

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James

@jprgooch

1 year

All I’ll say on the anon account issue is that I tweeted my experiences of trying to go LTFT and how HEE and local trusts treated me as myself and I got disciplined for it. My TPD was asked by HEE to monitor my tweets even though they were purely factual and did not name anyone.

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@jprgooch

2 years

My prediction for UK medical workforce planning is that individual depts will work with private providers/other trusts to create CESR programmes or routes to Specialist therefore entirely working around HEE and “formal” training. It will create flexibility unavailable otherwise.

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@jprgooch

2 years

I’m 10 years down the line now but it all rings so true. Practicing medicine in the NHS is no longer worth it. I’ve found my own way to make it work but if I was an FY1 now I’d either leave the UK or medicine. It’s that simple.

The News Agents

@TheNewsAgents

2 years

“I’m on a night shift, we’re doctors down, I’m dealing with patients who are seizing, another who is dying, all of this and you’re paid £14 an hour.” Junior Doctor, Josh, is grateful for his £28k salary but says the gruelling demands of the job means NHS doctors deserve more.

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James

@jprgooch

1 year

For me the real questions I want answered about AAs is about implementation. If we are moving to a system of me taking on liability for 3 theatres running simultaneously while running a peri op clinic/ward round then I do not want to be a consultant. It’s that simple.

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James

@jprgooch

2 years

Unprotecting my tweets now that HEE no longer control my career. Read in to that what you will.

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@jprgooch

2 months

@DrNeenaJha Unbelievable isn’t it? To quote the post office inquiry: “there were so many forks in the road where leaders could have made the right decision - but they made the wrong one, every time.”

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@jprgooch

2 years

I hope everyone at @RCoANews is aware they are destroying the speciality. Somehow, I doubt it. Arrogant, ivory tower climbers so disconnected from their fee paying members that they post a front page article on how pointless their own exams are because - just become an AA! -

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@jprgooch

1 year

My TPD was great and acknowledged I met social media rules but that HEE did not want me tweeting criticism of them. So glad I left training. My life is infinitely better out of the NHS.

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@jprgooch

3 years

The NHS should look at how Goldman is committed to provide better conditions for its junior bankers & think; “THERE’S AN IDEA!” We could start with somewhere to sleep on nights, access to food 24/7 & to receive pay & annual leave on time. Let’s start treating people properly.

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@jprgooch

2 years

@BellaRoscetti Get on to the BMA ASAP. Send all the emails. Go nuclear. People *must* be held accountable.

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@jprgooch

5 months

I feel so lucky I didn’t have to do the MSRA to get my anaesthetic CT post. I never would have got in. If you’re a London based anaesthetic trainee with an interest in ITU and missed out then DM me 😊

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James

@jprgooch

1 year

Horribly clickbaity. But also.. Why is it always educationalists +/- Jeeves? No wonder we lost in 2016.

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@jprgooch

1 year

I would like to add that I currently work 24h shifts in the private sector and they are *considerably* better than a week of nights - even with complex patients. I get fed, watered and a bed with fresh bedding every shift. I imagine similar to the “old days” and it’s great.

Sanchit Turaga

@srturaga

1 year

Context is everything. Older generation did have longer hours but less complex patients, less expectations, free education/free accommodation. Comparison with 40 years ago is not worth the time for #PayRestoration

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@jprgooch

2 years

Spending the morning reading the BMA election statements and I’m loving it. So many “junior” doctors saying it how it is and talking openly about industrial action to restore pay and conditions if demands not met. Let’s hope the BMA becomes a trade union again. We need it!

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@jprgooch

1 year

@drmattuk I had 3 much needed months off to recover. After 10 years I realised the job had made me deeply ill. Then I got a job as an RMO on ITU in a private London hospital to pay the bills but it ended up being fantastic so I’ve stayed, increased my hours and am building a career.

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@jprgooch

2 years

Sad to say I have resigned from my GP training programme. Onwards and upwards! Actually feel quite liberated having made the decision. Time for a break from full time clinical medicine. Unfortunately, for me, it is no longer sustainable.

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@jprgooch

1 year

I’ve never been a huge fan of meded types. Never been able to work out why. They’re just messing around and trying different stuff until something sticks, right? Meanwhile no one looks at the fundamental issues within FY training and the reasons we can’t retain any F2+ docs.

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@jprgooch

2 years

It’s an absolute farce. I gave up on HEE training. It’s a failed system and I think it will fail those who enter it now. Total disgrace and people need to be held accountable. Also, it will make the FRCA pointless once it does fail. Surprised the college aren’t more angry.

Dominic

@D_Rodders

2 years

Just as well there's a whopping 89 ST4 jobs avaliable in England and Wales for August 2023 intake.

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James

@jprgooch

1 year

I think an investigation is warranted to be honest. The workforce is on strike, the NHS is haemorrhaging doctors & there is no light at the end of the tunnel. The architects of this mess must be held accountable - HEE are a huge part of this and have acted with impunity thus far.

NHS England Workforce, Training and Education

@NHSE_WTE

1 year

This is the last week of HEE and we are looking back at what we have achieved over the last 10 years. Share your memories by commenting below with your memory or achievement of working for HEE using #HEE10 Find out more here: #HEE10Event

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@jprgooch

1 year

I’ve heard HEE told the College the ANRO mistakes are “a couple of isolated incidents” and so the contract will not be reviewed. These are people’s lives. HEE doesn’t give a shit about them or anyone else in training and it really shows.

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@jprgooch

2 years

And just like that I am no longer an NHS employee. …looking more and more like a sensible decision 😅

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@jprgooch

2 years

Bonus of finishing a 24h intensive care shift in central London… @Dishoom breakfast.

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James

@jprgooch

10 months

I got promoted so I’ve ordered a pie and a large glass of red wine then I’m going for an expensive glass of whisky in a whisky bar in Inverness.

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@jprgooch

7 months

This is going to be very, very expensive in the long run. Utterly moronic move initiated by a spreadsheet mentality that has infected our executive leaders across the UK.

James Steen

@BMA_James_Steen

7 months

This is lunacy. Patients everywhere report difficulty in securing GP appointments. Yet this practice deems GPs surplus to requirements in a GP service?! 🤯 The replacement of doctors, particularly GPs, is a false economy and is a danger to the public.

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@jprgooch

1 year

All this talk of FRCA exams and lack of training places makes me very happy I told them all to fuck off and moved on. It just isn’t worth it.

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@jprgooch

4 months

Today I had my first ever drum lesson. It was awesome. I’ve bought an electronic kit. Medicine took my creativity from me for a decade or more and I’m taking it back.

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@jprgooch

1 month

There isn’t a day goes by I don’t rejoice that I resigned from GP training. @NHSEngland (HEE) treated me like shit, told my TPD to monitor my tweets (because I asked to go 80% & trust refused), I earned nothing & the “training” was lots of show and tell circles. Now no jobs.

PulseToday

@pulsetoday

1 month

NHS England director admits GP trainee jobs ‘are not there for them’ #GPworkforce #GPaccess

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@jprgooch

1 month

Love that the @gmcuk news email doesn’t include the fact that they’re being sued by @TheBMA .

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@jprgooch

11 months

There must be consequences and it should lead to managers being registered and held to the same standards doctors are.

Mamas A. Mamas

@mmamas1973

11 months

This is so messed up- paediatricians that raised concerns were forced to write letters of apology to the UKs biggest murderer of babies and were reprimanded - and managers who covered up her actions have had no consequences. Doctors ended up going to the police themselves as the

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@jprgooch

2 years

Not a single doctor believes we have real support in making these “difficult decisions”. History shows clinicians are thrown under the bus when these gambles go wrong. The stress of this can not be understated. Direct route to burnout.

Shaun Lintern

@ShaunLintern

2 years

🚨🏥 "Our hospital capacity is at its absolute maximum. We are now having to look after patients in non-bedded areas..." Critical incident declared at @ESHTNHS

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@jprgooch

3 years

@RobJimFleming My best advice was from the former head of school for EoE who said to me: “Training is a square hole and you are a triangle. You either need to make yourself a square as soon as possible or create your own triangle shaped hole. Ultimately the holes all lead to the same place.”

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@jprgooch

1 year

@danny_mercer I think we’re all discovering that HEE was never about education…

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@jprgooch

1 year

@ShaunLintern @HarryYorke1 No one to train them, universities already unable to cope with med student numbers, placements that don’t exist etc etc. This won’t work. Retention is their only hope of salvaging the system but they won’t budge in order to save face. It’s embarrassing.

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@jprgooch

2 years

Taking my mind off how the UK is on fire by thinking about how lucky I am that my partner can make such a good pie.

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@jprgooch

2 years

If I’d kept my guitar in the ITU office it would have had a pigeon nesting in it. Also, if we all learn to play an instrument you can bet it would crop up in the FRCA. “If you play an acoustic guitar in 80% humidity for a week tell us how the sound of a F# chord would change.”

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@jprgooch

2 years

Walthamsnow last night.

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@jprgooch

8 months

Agreed, HEE threatened me via my TPD and asked me to stop criticising them on social media precisely *because* I had hard evidence of impropriety.

Steven Alderson

@StevenMAlderson

8 months

@drcolinm You’re out of touch on this one, Prof. Trainees are afraid of the GMC. They are afraid of HEE & the LETBs. And with good reason - the former is responsible for innumerable suicides; the latter for serial careers ruined. Anonymous SoMe feedback is the future. Leaders can act…

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@jprgooch

2 years

@GasDocYates @MHA_92_ @TheBMA It does feel like it’s time to start naming and shaming.

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@jprgooch

3 years

Today has the feel of one of those night shifts where everyone goes “is there a full moon or something?”. I’m on edge, patients are particularly unhappy and there’s a feeling of sadness in the air like we’re already mourning the days we are yet to lose.

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@jprgooch

4 months

@GasDocYates Our doctors are usually senior trainees who can no longer access education funding from the NHS. We pay for their PhD or masters etc if they give us a shift or two a week.

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@jprgooch

1 year

@mrseleanorohara I work for HCA in one of their London hospitals. I enjoy doing ITU again and I’m starting a masters with them in executive medical leadership.

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@jprgooch

2 years

Anyone know of recruiters that specialise in ex-medics who want to work outside medicine?

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@jprgooch

1 year

Dear UK public, We told you so. KR, Doctors P.s. you’re fucked.

Ben Evans

@criticalgassing

1 year

GMC 2023 report makes for terrifying reading; 77% are planning to make a career change. Adverse effects on wellbeing was the most cited reason for leaving (75%) Many plan to move abroad with 80% saying it's because doctors are treated better and 66% due to higher pay. (1)

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@jprgooch

3 years

Said to family please don’t open oven while the Yorkshires are cooking. 5 times. FIVE. Livid.

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James

@jprgooch

9 months

Yet another day of being glad I’m no longer an anaesthetic trainee. On that note…if anyone is stuck in the bottleneck with anaesthetic/ITU experience (pref with cardiothoracics) and wants a flexible ITU job in a lovely team in London DM me 😊

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@jprgooch

1 year

Congratulations to all those who passed the FRCA today. Also a reminder to those who didn’t that it doesn’t define you and it doesn’t correlate at all with your ability as an anaesthetist. (1/2)

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@jprgooch

3 months

I’d like to publicly add my name to the list of people that really needed this service, especially after covid. My local occupational health did sweet FA and actually referred me to this. I’m fairly confident I wouldn’t still be in medicine if this service didn’t exist then.

NHS Practitioner Health

@NHSPracHealth

4 months

Important service update.

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@jprgooch

2 years

@drjeffphillips Training just needs to be better.

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@jprgooch

3 years

Off to Inverness on the @CalSleeper for a week away to escape “freedom day” in London and to ride around in the middle of Loch Ness on a boat instead.

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@jprgooch

1 year

Now *this* is potentially very exciting from @RCoANews CESR programmes registration would be game changing and allow a whole new training market to open.

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@jprgooch

22 days

First result on the bingo card!

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James

@jprgooch

1 year

My bag was stolen yesterday. I traced it to @TheMayFairHotel bar last night where they wouldn’t let me in to have a look (Hamza - you’re a dick). Police said they couldn’t help (1/3)

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@jprgooch

1 year

However, I am clearly a super policeman as I have retrieved my AirPods when the @metpoliceuk said it couldn’t be done! Confronted the thief and got it back. Bag and glasses gone. Maybe a career outside medicine is warranted after all! (2/3)

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@jprgooch

4 months

I am actually really surprised by this. I didn’t think the RCP would have massaged their figures to this degree. I mean, this could be a GMC referral about probity if it was a trainee. A real eye opener and a real shame. No wonder he resigned.

Royal College of Physicians

@RCPhysicians

4 months

Following the #RCPEGM on the role and regulation of physician associates (PAs), the RCP has now published the full data from its pre-EGM member survey.

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@jprgooch

1 year

This workforce plan is just…not a workable plan. I don’t know a single person in the system who thinks this is even possible unless we fix the huge problems that already exist. Who will train them? What do we cut from the curriculum? How do universities make it work? No detail.

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@jprgooch

13 days

Aaaaaaand after a gruelling 28 hours of continuous consciousness I am celebrating having arrived in Bali with a martini.

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@jprgooch

4 months

@GasDocYates Not at all! Much the same as the NHS to be honest. We have a large medical service so if oncology patients become neutropaenic for example we intervene and they can have that higher level care. We also provide post op care including cardiothoracic and neuro.

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@jprgooch

1 year

To @RCoANews I say reflect on the messages of successful candidates saying they can “live again”, “see my kids”, “unpause my life” etc and whether perhaps you could do more for your trainees in the 21st century. You certainly seem to want to modernise everything else… (2/2)

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@jprgooch

8 months

I’m increasingly less interested in listening to anyone preaching about the state of the medical workforce who didn’t work on the wards/ITU during covid.

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James

@jprgooch

2 years

Oh and they’ve got my pay wrong for August as a goodbye present.

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@jprgooch

4 months

I made Ravioli from scratch tonight (was too keen to eat to plate properly). Tuesdays are going to be “things I haven’t cooked before” nights.

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@jprgooch

2 years

I have now gone to @Dishoom Carnaby for breakfast after every night shift on intensive care for the last month and I think this might be my life now.

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@jprgooch

2 years

@doctorhelgi @NHS_HealthEdEng When are we going to admit that HEE are unfit for purpose and need to be disbanded?

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@jprgooch

1 year

@cinema_astra It’s much more about conditions. I get treated like a human. I am not a slave to the public. I did 10 years public service and served through a pandemic on ITU working 100h weeks sometimes, often unpaid. 3 colleagues killed themselves. How much more do you want from me?

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@jprgooch

1 year

We need to uncouple training from HEE. They have shown themselves to be a corrupt organisation that serve only to throttle the number of doctors who complete training. CESR and CCT must be seen as equal by GMC. It’s the root cause of so, so much.

Jonny Guckian

@JonnyGucks

1 year

We need a national, cross-specialty conversation on physician recruitment. The points system has been broken by industrialisation & an 'arms-race'. SJT-type assessments subject to differential attainment & unevidenced. Interviews subject to bias. What do we do? #medtwitter

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James

@jprgooch

10 months

This weekend @andyday333 and I brought home our two boys, Benny and Björn.

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@jprgooch

11 months

@amateuradam Agreed. But how much you want to bet that some of those M&M minutes for those babies say “lessons learned” in them? The whole culture needs to change.

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James

@jprgooch

10 months

@morefluids FRCA split in to 3 smaller exams that run 4 times a year and review the syllabus properly. Run through. Rotation only for specialities not available locally. Shorten by a year but 1st year consultancy includes residential on calls.

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James

@jprgooch

2 years

Just to post a positive tale about sleeping arrangements at night. The hospital I worked in had the on call room removed for ITU but the consultants paid for us to have a sofa bed in their office so we could get some rest.

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James

@jprgooch

3 years

First day back anaesthetising since June (as a locum). Let’s see how this goes!

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James

@jprgooch

1 year

Just got hit at Oxford Circus by a cyclist and nearly by another. About 10 of them jumping the red light in their expensive gear and weaving through pedestrians. As someone who’s been knocked off a bike before I still find this unreasonable.

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James

@jprgooch

1 year

Lunchtime ❤️

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James

@jprgooch

2 years

Exams are just not worth it any more for the pay and conditions. I’d rather live life, thanks.

Amy Garner

@DrAmyGarner

2 years

This is the reality of post-graduate exams. My 2yr old daughter staging a “sit in” as a protest for me needing to revise for #FRCS today rather than spend the time with her that she deserves. The impact of taking exams as a “grown up” is widespread and understated. #orthotwitter

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James

@jprgooch

2 years

@AbdnAlan An important but impossible question to answer. It’s death by a thousand cuts. We’ve been complacent and allowed so much to be lost. Pay, free accom, parking, scope creep, NHS bursary, pay, curriculum changes, exam fiascos, pensions, pay…each week we seem to suffer another cut.

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James

@jprgooch

2 years

@jackiecassell @NHS_HealthEdEng Oh no - last time they saw my tweets they told my supervisor to tell me off for criticising them and publishing an anonymised email *they* sent to me as they didn’t like the content.

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James

@jprgooch

2 years

@MJTB1987 That remains to be seen 😂

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