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N Miranda

@miranda_nigel

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GP Trainee & Passionate Photographer. Vote for policies, not for parties or people. #doctorsvote #fullpayrestoration

Joined March 2020
Don't wanna be here? Send us removal request.
@miranda_nigel
N Miranda
1 year
MPs have had real terms pay rises for running the economy into the ground whilst giving their donors & cronies contracts & jobs worth millions of £££ Their salary as of 2022 is £84,144. They also get massive deductions and subsidies for bills, food, staff etc.
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@miranda_nigel
N Miranda
8 months
Apprentice Physician's assistants can now get paid at band 5, same as a fully qualified Nurse or a year 1 Doctor without any of the training. Requirements include 1. "interest in the subject matter" 2. Experience of health care desirable but not essential, but managing a
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@miranda_nigel
N Miranda
6 months
@VictoriaAtkins What happened to the supposed offer in your back-pocket? Doctors now not on strike and no new strikes have been called. When are you going to do your job and actually negotiate a deal? No negotiations during strikes was a foolish self-imposed policy as it is!
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@miranda_nigel
N Miranda
5 months
@itvpeston @VictoriaAtkins @ITV I think the country needs to vote to force all MPs and their families to only be able to use public services like the NHS, schools and rail. It'd be a utopia overnight. All these corrupt ones will disappear into the woodwork and we'll have politicians with integrity.
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@miranda_nigel
N Miranda
5 months
@BMA_Consultants Consultants commitee has done the profession a grave injustice. The whole process has been rife with mismanagement. Putting a horrible offer to the consultants has now led to this pathetic outcome. Now you're all left with almost no negotiating power. Congrats 👎🏻
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@miranda_nigel
N Miranda
1 year
@JoCheetham1 @gloshospitals I've said it before and I'll say it again. Having to pay our employer to be able to come to work is just a step shy of Debt Bonded Labour. Depending on how much disposable income you have at the end of the month, it may actually BE debt bonded labour.
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@miranda_nigel
N Miranda
8 months
@ExplosiveEnema @LittlePersonDoc @parthaskar @mmamas1973 @DrRaviJ @birmingham_live @joelycett We keep hearing that there are ONLY 3000 of them nationwide. But the degree to which scope of practice is ignored is astounding 😵 covering a specialty Registrar rota?!?!
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@miranda_nigel
N Miranda
1 year
@drmattuk B..b..but it all evens out when you get paid £500,000 a month as a consultant in 3 years, which happens automatically without any extra exams or work!
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@miranda_nigel
N Miranda
5 months
@KamilaRCGP ARRS funding including GPs would be the easiest overnight solution to begin with. Why are they so resistant to this obvious solution?
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@miranda_nigel
N Miranda
8 months
@DrEilidhMaria @hawkes281 Is there a legal basis for doing this? I understand the "it all evens out" argument, but that doesn't really count in this case if the schedule doesn't permit that to happen. Will need to go through the 2016 contract later and see 🤔 Even without this issue, our enhancements
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@miranda_nigel
N Miranda
3 months
@drmattuk @fascinatorfun @GrumpyOldDoc @GMCharlatan @medicalmodelbri You have the support of the wider profession on this, Matt! This is a delay tactic and it's not going to work. Glad to have someone speaking out for us! Not many of us could take the abuse that you've been forced to and still come out strong ✊🏼
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@miranda_nigel
N Miranda
9 months
@dr_merritt Do you not consider concerns valid in your trust if they're raised anonymously? The CMO saying this says a lot about the freedom to speak up at your trust. "I don't recognize that", pretty much tells us all we need to know. What's it going to take for medical leaders to
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@miranda_nigel
N Miranda
6 months
@parthaskar @iDrSunny @Parody_RCGP @mmamas1973 @DrAsifQasim Truly I am grateful to the RCGP and its leadership for these fees and exam costs which I must pay out of my own pocket, despite being mandatory. I'm also grateful for a portfolio I must also pay for out of pocket. Tremendously helpful in this cost of living crisis.
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@miranda_nigel
N Miranda
8 months
@DrEilidhMaria They should not be allowed to take up any doctor shifts, locum or otherwise. Need a separate rota with their own shifts and locums just like nurses and every other profession do. No reason for a totally separate profession to share our rota and opportunities.
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@miranda_nigel
N Miranda
5 months
@Xeon4f145d96s1 Med school Paeds, treating children daily in A&E for 2 years (with supervision when needed), and now a 6 month rotation in Paeds for GP training. It's taken years to build a decent FOUNDATION. Vs. This person going in "blind" and not feeling out of depth.💀 Must be a genius.
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@miranda_nigel
N Miranda
8 months
@DrAsifQasim @mrbinmonster 100% support from a GP trainee!! Thank you Dr. Qasim for thinking of trainees and our interests!
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@miranda_nigel
N Miranda
5 months
@VictoriaAtkins Maybe offer them an MP salary and expenses. That'll get a 100% yes vote. They do far more for the country as it is. MP salaries have kept up with inflation too. How convenient. All due to the *independent* pay review body I'm sure.
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@miranda_nigel
N Miranda
8 months
@Dr_Done_ This is a very popular opinion 🤣
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@miranda_nigel
N Miranda
1 year
Never thought I'd enjoy a cup of tea so much. Voting yes for Full Pay Restoration! #fullpayrestoration #doctorsvote #BMABallotReady
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@miranda_nigel
N Miranda
1 year
Honestly should have done this course when I started working in A&E. Why is mastering core ultrasound not a part of med school curriculum, given its broad applications in every speciality? I'd rather do ultrasound than 50 pointless log books and reflections.
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@miranda_nigel
N Miranda
1 year
@MustafaBoorenie Would seek BMA advice asap and request evidence that the £450 was used to purchase a new bleep. God knows what they're actually wasting it on.
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@miranda_nigel
N Miranda
8 months
@Dr_Done_ "Automatically" leaves a lot of wiggle room doesn't it? But definitely understand why it's been added. The other issue is being labelled as a trouble-maker by permanent staff. Difficult to navigate this as a rotational trainee.
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@miranda_nigel
N Miranda
9 months
@Leicnut @RobLaurensonD4P PAs should not be discussing cases with doctors who are not in supervisory roles anyway. If consultants want them in the dept, they must bear the burden of supervision, prescriptions and ordering scans.
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@miranda_nigel
N Miranda
1 year
@Doctors_Vote Accurate analogy. None of these ministers are anywhere near qualified to be in charge of health, safety, economics etc. Schoolboy Steve needs to wake up and do his job as health secretary.
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@miranda_nigel
N Miranda
6 months
@Xeon4f145d96s1 @Iromg He knows we'll be there to bail him out for free when he gives himself a stroke from living with so much hate and vitriol. Ironically he may not reach the hospital in time because the party he serves has destroyed the ambulance services and response times.
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@miranda_nigel
N Miranda
8 months
@gaslad Why would one ever need a locum PA when there are many long term locum doctors available for the same rate? This is really fishy...
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@miranda_nigel
N Miranda
2 years
Doctors at the mercy of power-tripping admin. University, Internship, Work life. When will it end...
@DrAPMD
AP, MD
2 years
I thought coming home after finally finishing the USMLE step series would be such a victorious moment. Instead I’m replaying the moment where my examiner told me he “did not like my attitude” and proceeded to turn off my computer MID-EXAM.
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@miranda_nigel
N Miranda
9 months
@Dababydoc @RobLaurensonD4P I'm a GP trainee, and I think you're going to see a shift in mindset in the next few years. A significant % of the current cohort of trainees are not going to abide with scope creep. Sounds like your dept policy is perfectly sensible even if it creates slightly more paperwork
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@miranda_nigel
N Miranda
5 months
@AlisonGeorge10 @DrSteveTaylor @KamilaRCGP @rcgp @UniOfSurrey @DAUK_GP @BMA_GP @KeeleyMP Strange, isn't it? RCGP leaders are focussed on PA development while GPs are starting to be phased out. I've read the RCGP manifesto, and it's words are totally at odds with what they're actually doing.
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@miranda_nigel
N Miranda
1 year
@thegradmedic Because apparently, we will get paid much more as consultants in a few years so it evens out. You won't get much more than broken logic when discussing this topic with them unless they're actually capable of being objective.
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@miranda_nigel
N Miranda
6 months
@Dr_Done_ What kind of nonsense consultation is this? It just asks if we can understand the framework again and again. Not if we agree or disagree with the content. We have to explain ourselves with each badly phrased question just so we're not mistakenly agreeing with their proposals.
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@miranda_nigel
N Miranda
6 months
@hope_155 @muddy_gas_doc @Suburbanbella if you want a laugh. Do Doctors in the States ever have to deal with criticism for not doing the housekeepers jobs? Then get accused of "thinking you're too important"? The never-ending gaslighting and guilt-tripping does take it's toll, I must say.
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@miranda_nigel
N Miranda
6 months
@Suburbanbella It's a massive government push for these roles to reduce doctor bargaining power and strike effectiveness, and to show on paper that NHS staffing has improved. All at the expense of patient safety and doctor working conditions.
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@miranda_nigel
N Miranda
6 months
@DBDouble @medicalmodelbri If ARRS funding included GPs, who do you think the practice would hire? Do you think they'd still find it difficult to find GPs?
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@miranda_nigel
N Miranda
5 months
@BMA_Consultants AND YOU'RE NOT STRIKING. Ingenious. @Doctors_Vote the consultant commitee needs a massive overhaul, it seems. Hope you guys can do your magic somehow and promote union leaders who actually know what they're doing.
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@miranda_nigel
N Miranda
1 year
@CatrionaRennis1 Email HR & Payroll asap. If not responsive, give them deadlines to respond - leave a papertrail. Involve dept. heads and directors early if still no response. I was double billed for a month of hospital accommodation, and the further up the ladder you go the quicker its resolved
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@miranda_nigel
N Miranda
5 months
@parthaskar @ollieburtonmed Need people like yourself with integrity in these positions. I was hoping desperately that @Jcalcolado would stand for RCP president, but unfortunately we're stuck with the current lot who only want titles and an OBE.
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@miranda_nigel
N Miranda
3 months
@doctor_oxford @RCPhysicians Beautifully written letter. Only change I'd make to this is remove the word "apparent".
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@miranda_nigel
N Miranda
6 months
@Dr_Rajiology You've hit the nail right on the head there with "Orwellian". This is unbelievable! Might as well be accusing us of thought crimes. They've already got the framework for it with #bekind
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@miranda_nigel
N Miranda
6 months
@Dr_Rajiology @ClareGerada @mari_fonseca @Dr_BellaR @ASiTofficial GP trainees have just received a BMA survey to fill in yesterday. The data will soon be available and our opinions evident. One hopes that our royal college which we are FORCED TO PAY FEES FOR will REPRESENT OUR INTERESTS FIRST instead of other professions.
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@miranda_nigel
N Miranda
6 months
@muddy_gas_doc @chebbes While your intentions are clearly good, even doing this sets a precedent. Next thing you know it'll be part of our unofficial duties.
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@miranda_nigel
N Miranda
1 year
Trust Accommodation dept raising "service charges" (rent) by 35% within the span of a year. This wording is so galling. Who exactly do they think takes care of patients if not the tenants they're overcharging Increase of ~£800 in total for the shared flat I'm in. What a travesty
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@miranda_nigel
N Miranda
8 months
@Dr_Done_ There will be a consultant radiologist to sign off and be the liability sponge.
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@miranda_nigel
N Miranda
6 months
@VictoriaAtkins Sounds like incentive for you to do the job you're overpaid to do and actually negotiate. Maybe if you did your job instead of standing on a flawed principle not negotiating during strikes, there might be a resolution. Continued failure. Barclay and now Atkins. Useless.
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@miranda_nigel
N Miranda
1 year
@RoshanaMN @SteveBarclay @RishiSunak @Jeremy_Hunt @wesstreeting @Keir_Starmer I paid £23 for a haircut the other day which took around 30 mins. ��46 per hour for a haircut. My hourly salary as a doctor with 3+ years experience is £19/hr.
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@miranda_nigel
N Miranda
1 year
@tsharp1093 Colleague of mine who works as Ortho F3 was not taught anything apart from clerking in F2. First time he learned to relocate a shoulder and manipulate a fracture is when I showed him in A&E last month. Pure service provision without teaching is a disgrace.
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@miranda_nigel
N Miranda
10 months
@alastairmiller3 We wouldn't be in this situation if people in your position actually supported juniors. This is just sad. The union is better off with a unified voice at present 👍🏼
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@miranda_nigel
N Miranda
6 months
@medicalmodelbri @Suburbanbella just thought you'd be interested to see the extent it's gone to here in the UK too. You guys certainly aren't alone. A primary care clinic running without a single GP. I did my undergrad in India and we have different issues with total quacks (homeopaths) running
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@miranda_nigel
N Miranda
1 year
@DrIvyprofen I would never use that term myself as it doesn't represent us adequately as highly skilled professionals. Junior or Senior, I'm a doctor. I won't claim to be a specialist/consultant if I'm not, but anyone who is fully licensed and with a medical degree is a Doctor.
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@miranda_nigel
N Miranda
1 year
@trentconsultant @ipsaUK This chart is also CPI instead of RPI, which would be even worse. I think it's a good idea to show everyone these charts comparing MP pay to the rest of the public sector. They're happy to give themselves a pay rise but "can't afford it" for anyone else.
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@miranda_nigel
N Miranda
9 months
@dr_merritt By the way, I'm acutely aware of the power differential here in commenting on a CMOs post in disagreement as an IMG trainee with a possible GMC complaint always hanging over my neck. But if anonymity is the only thing thats the issue here, then so be it.
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@miranda_nigel
N Miranda
7 months
@ExplosiveEnema @parthaskar @birmingham_live @drjcdarling @MichelePaduano @JanetEastham @Xeon4f145d96s1 @LittlePersonDoc @DrRaviJ @BWC_NHS Cannulation is desirable but not essential. More work for the doctors then, while they sit and learn in clinics
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@miranda_nigel
N Miranda
7 months
@Jcalcolado @RCPhysicians The tide seems to have changed this year and RCP desperately needs someone like you at the helm! Otherwise it's just going to be the same old excuses and following the status quo...
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@miranda_nigel
N Miranda
2 years
@Gastronaut89 "Gave you" those locums is a window into the mindset of this person and admin in general. This doctor "gave" them a job, seeing as how people come to hospitals to see healthcare staff.
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@miranda_nigel
N Miranda
1 year
Just been told my hospital accommodation cost is going to increase by ~20%. They already increased it by 15% about 6-7 months ago. So a ~35% increase in the span of a year Salary went up 2% though Sounds fair I guess 🙄 Wish we got housing expenses like MPs #fullpayrestoration
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@miranda_nigel
N Miranda
6 months
@Suburbanbella @Xeon4f145d96s1 Any chance of you touring the UK and speaking about this to doctors? I'm only half joking 🥲 People need to hear first-hand what the future holds if we continue down this treacherous and senseless path.
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@miranda_nigel
N Miranda
4 months
Any other GP trainees also concerned about affordability of the @rcgp AiT renewal fee after year on year sub-inflationary pay rises? This being a mandatory portfolio, there's no way around it, sadly 😢 @BMA_GP £423 for membership and portfolio.
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@miranda_nigel
N Miranda
1 year
@thegradmedic I see nothing wrong with them having a high wage, but doctors MUST be remunerated fairly, which means a higher pay than them because: 1. Better qualified 2. Can prescribe + scans 3. Responsibility if something goes wrong 4. Regulated profession I have more but won't fit here.
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@miranda_nigel
N Miranda
1 year
@RobLaurensonD4P @Doctors_Vote At this point we need to come up with a great slogan as a response to "our door is always open". Charlatans
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@miranda_nigel
N Miranda
6 months
@UKGastroDr We have to study innumerable foolish SJT questions and it's drilled into us from day 1 that patient safety is the #1 priority. Is it time for other professionals to be held to the same standards? I can't go around calling myself a trainee consultant or a consultant SHO after 10
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@miranda_nigel
N Miranda
6 months
@BMA_James_Steen Proud rabble here 🤣 thanks to the BMA and DV for rousing (not arousing) us ✊🏼
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@miranda_nigel
N Miranda
7 months
@cannula_service Forcing consultants to enable the government's terrible long term workforce fiasco. You'll all be stuck spending your SPA time training PAs, AAs and other non doctors. Horrible deal that needs to be rejected.
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@miranda_nigel
N Miranda
5 months
@Dr_Done_ I don't see how this would work though, because literally anyone can wear one. It's not something that just physicians can do. I'd be happier wearing a watch as a form of protest. 100x more useful and ridiculous that we can't wear one.
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@miranda_nigel
N Miranda
1 year
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@miranda_nigel
N Miranda
6 months
@iamSwaga22 @Microbedoc2 @thepigonthewall Idk about you guys but I did the hippopotamus oath and I've never broken it. 😎
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@miranda_nigel
N Miranda
1 year
Many of us have sent emails about this but they're not particularly bothered that we've lost pay due to inflation and are raising charges twice in a year. Do not ever feel guilty about striking for #fullpayrestoration They will keep taking until you have nothing left.
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@miranda_nigel
N Miranda
9 months
@ConkerLover @RobLaurensonD4P @MPS_Medical To be fair, we don't need MPS to weigh in. GMC guidance is crystal clear. We bear full responsibility for anything our signature or name is on. They are not regulated.
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@miranda_nigel
N Miranda
7 months
@DavidGWrigley Gosh, they'll do anything but fund GP properly. Ridiculous.
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@miranda_nigel
N Miranda
8 months
@duffett_claire @KatrinaSheikh Crabs in a bucket mentality helps nobody. We're all campaigning to restore pay we've already lost, not for a pay rise. It's only difficult to understand for those with an agenda. Everyone else has lost 3% whereas doctors have lost ~25%.
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@miranda_nigel
N Miranda
6 months
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@miranda_nigel
N Miranda
5 months
@Xeon4f145d96s1 The fact that RCP members' fees are being used to fund FPA really rankles. Let them set up their own organization if they want, determine their own scope as they please. If it doesn't line up with royal college scope limits then doctors must refuse to train beyond RC scope.
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@miranda_nigel
N Miranda
7 months
@Craigdiablo @jdpoc *there The waiting list began to increase from 2010 according to this graph which you seem unable to decipher. The pandemic was in 2020.
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@miranda_nigel
N Miranda
7 months
@drsamyar Is there no way to propose the conference be moved up in schedule? The govt and GMC are racing to get what they want. No scope for an EGM style conference to bring up this issue? Needs to be voted on ideally before PA regulation amendment goes to parliament.
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@miranda_nigel
N Miranda
8 months
@charlotte_e_ray @hkg294 @jimmy_jone388 Doesn't fit her narrative of claiming equivalence. 10 years driving my car doesn't make me an F1 driver. 10 years as a PA doesn't make one a doctor.
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@miranda_nigel
N Miranda
9 months
@Xeon4f145d96s1 How is it always some nameless cog in the machine sending these emails? Whoever sent it must put their name to it. But hey, professionalism is only for clinical staff, it seems. Admin can do whatever they want and we just have to suck it up.
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@miranda_nigel
N Miranda
8 months
@iDrSunny @parthaskar @RCPhysicians @doctor_katie @doctor_oxford @mmamas1973 @OrthopodReg @RobJimFleming @DrSelvarajah @doctorhelgi @drphilhammond @HelenRSalisbury @timricketts_ @DrEilidhMaria @drmattuk @DrLindaDykes Most initiatives for addressing these issues internally are for show, arent they? Haven't yet actually heard of a case of whistleblowing where the involved wasn't targeted by management for fighting for staff/patient safety.
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@miranda_nigel
N Miranda
1 year
@thegradmedic Not a single coherent sentence about why they think your ideas may be incorrect. Just personal attacks fuelled by jealousy. Didn't have the guts to post from their actual account either 🙄
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@miranda_nigel
N Miranda
1 year
3 days after I did this course, I've ruled out a AAA in a pt with hypotension & sudden abdo pain. CT & bloods were delayed due to unforseen circumstances but was able to do a POCUS & explain findings to pt & relative. Thanks @codingbrown for supervising!
@miranda_nigel
N Miranda
1 year
Honestly should have done this course when I started working in A&E. Why is mastering core ultrasound not a part of med school curriculum, given its broad applications in every speciality? I'd rather do ultrasound than 50 pointless log books and reflections.
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@miranda_nigel
N Miranda
5 months
@quackophage *SOME* reputational impact? The BMA has repeatedly said GMC is unfit for purpose. They have no reputation left to lose...
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@miranda_nigel
N Miranda
4 months
@DrSteveTaylor Seeing many of the usual suspects on this one list. I firmly believe (maybe incorrectly) that a single frontline staff member has done more for patients than any of them. Sure, might not be great at photo-ops, but when a pandemic hits, we're there. How many on this list were, I
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@miranda_nigel
N Miranda
8 months
@DrEilidhMaria @hawkes281 If the posting duration was a multiple of the work schedule duration it would , but in situations like this it doesn't. Awful
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@miranda_nigel
N Miranda
6 months
@NHSHandSan Not rotate 🥲
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@miranda_nigel
N Miranda
4 months
@Peterchromocyt As an IMG, couldn't agree more. That's even if the training bottleneck situation weren't an issue - it's the principle of the matter. I've already got a training number though, so saying this does feel like ladder-pulling :(
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@miranda_nigel
N Miranda
1 year
@mjv__1 @JRCPTB Every insult like this just adds more fuel to the fire of pay restoration.
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@miranda_nigel
N Miranda
1 year
Other sectors have recovered but doctors and consultants still facing MASSIVE cuts. 6% imposed pay rise is nowhere near enough to make up for worsening pay and conditions
@goldstone_tony
Dr Tony Goldstone
1 year
1/ VITAL🧵 So people have had a couple of days to digest the DDRBs "independent" reports & their imposition by governemnt. TLDR;they represent further MASSIVE pay cuts. Lets start with some history and look at what happened BEFORE the current high inflation Pls read all/RT
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@miranda_nigel
N Miranda
6 months
@Suburbanbella @medicalmodelbri We've had cases here where the above has happened but the PA association blamed the GPs for not supervising well enough with there being no consequences for the responsible person apart being removed from their voluntary register. They're soon to be registered under the Doctor
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@miranda_nigel
N Miranda
1 year
@RoshanaMN Every interview is the same with Sunak. Giddy with fake excitement while giving workers another pay cut relative to inflation. Could do well replacing Jimmy Fallon.
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@miranda_nigel
N Miranda
5 months
@iDrSunny @ExplosiveEnema2 @quackophage I think we need to set up crowdfunding for a watchdog organization. RCs, GMC, NHSE, HEE all need to be thoroughly investigated full-time by people who are highly motivated to do so. BMA is too busy catching up after decades of slumber.
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@miranda_nigel
N Miranda
1 year
@trentconsultant I'm concerned this pension plan isn't so much for doctors as it is to help their rich donors evade even more tax. Definitely helps consultants with the pension tax issue though, but they seem to be portraying it as just to help doctors 🧐 suspicious
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@miranda_nigel
N Miranda
3 months
@DrNeenaJha @DavidPNoble63 I think all these documents need to start having author names on them. The people responsible need to be held to account.
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@miranda_nigel
N Miranda
6 months
@PeteDav69 @Xeon4f145d96s1 @Iromg That's not how you proposition someone, mate 🤣 This is ironically the first time anyone has asked me that and the first time I've ever actually said that my pronouns he/him 🤣🤣 of all the people to ask pronouns, I didn't expect it to be some random nationalist nutcase 🤣🤣🤣🤣
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@miranda_nigel
N Miranda
5 months
@KirkwoodDW @ashleighlowther Their pay rises are obscene given what they've actually delivered to the country. Don't forget, they have practically unlimited expenses paid too, so their salaries go far more than any of ours do.
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@miranda_nigel
N Miranda
1 year
@beckybeckyfish Horrible thing for someone to do to you 😡 This is from Toxbase. Half-life is 16-35 hours
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@miranda_nigel
N Miranda
9 months
@SnotSurgeon @fessdoc I don't think anyone is against the existence of PAs as they were originally intended - to ASSIST doctors. Scope creep has become the issue of the times and is a totally undeniable reality. PAs performing Neurosurgery and running 2WW clinics?! Giving GPs over the phone advice?!
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@miranda_nigel
N Miranda
5 months
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@miranda_nigel
N Miranda
7 months
@QLDCountryGP @gem1509 In the Emily Chesterton case, the FPARCP blamed it on the GPs for lack of supervision. Absolutely no accountability. PA in question was suspended from their voluntary register I believe, but I've also heard that they continue to work as a locum in London.
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@miranda_nigel
N Miranda
6 months
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