Jan Klepacki

Physician, diabetes, endocrine
Humanist, science nerd
Passionate about social equality and education.
Outdoors enthusiast
Views own

[Jan Klepacki @JanKlepacki]

@parthaskar @RCPhysicians @DrLKVaughan @doctor_oxford @DrAsifQasim @EileenBurns13 @UKGastroDr @ShrillaB @COPDdoc @ShivaniM_KC @Zudin_P @respirologist Can they just do that without stating the reason?!

[Royal College of Physicians @RCPhysicians]

In 2024, applications for IMT outstripped the number of posts available by 73%.

‘We risk abandoning a generation of UK medical graduates to an uncertain future. We urgently need to understand why competition ratios are changing so quickly and improve the way we shortlist, interview and appoint doctors in training.’

Chair of our Student Foundation Doctor Network, @SeanCoghlan_, speaks out as we publish a new position statement on competition ratios.

In our new position statement, we’re calling on the UK government and NHS England to take this situation seriously and bring forward solutions in time for the 2026 recruitment round: https://t.co/hskUB1DQuI

[Dr Tony Goldstone @goldstone_tony]

This is not sustainable @wesstreeting. It’s also a gross waste of taxpayers money to be training people in the UK for them to have no job. So much for doubling medical student numbers - our brightest 16-18 year olds know to look at a graph like 👇and look elsewhere

[Dr Steve Taylor @DrSteveTaylor]

UK is facing a critical failure in medical workforce planning

Thousands of doctors are trapped in a bottleneck, blocked from progressing due to a shortage of training posts

A crisis that was foreseeable and entirely preventable
@wesstreeting @NHSE_WTE
https://t.co/VDfbVVptCT

[Dr Steve Taylor @DrSteveTaylor]

In a world where Kim Kardashian promotes whole body scans, the money men see the potential in guidable politicians & NHS leaders

CDCs connected to AI via an App

Healthcare is taken away from well trained, experienced clinicians who save the NHS £billions but what do they know🤷🏻‍♂️

[Fire Brigades Union @fbunational]

When firefighters are sent out in crews of just three in a fire engine, lives are put at risk.

The fragmentation of the fire and rescue service has led to a dangerous post-code lottery for firefighter crews.

To protect firefighters and the public, we need national standards.

[Dr sthanu subramanian @drsthanus]

Hyponatraemia

In order to investigate the cause of hyponatraemia, first check the serum and urine sodium and osmolality at the same time.

https://t.co/SuOQxbAfbp

[Ashwin Rajenesh MD @ashwinrajenesh]

23 year old female who was brought in an agitated and troubled state to the ER. She wasn't verbalising coherently and was unable to provide an account of her symptoms.
Caregivers in her family noted the restless behaviour, anxiety, palpitations and sleep deprivation with constipation; and were convinced she had "mobile phone addiction" and took her to a psychiatrist who started risperidone (a medication for psychosis) and benzodiazepines (sedatives) 3 days ago.
We noted bradycardia at presentation and an irregular pulse. This was her ECG.
Thoughts?
#MedTwitter

[Andrea Junker @Strandjunker]

Number of people who go bankrupt every year because of medical bills or illness-related work loss:

Australia 0
Canada 0
Denmark 0
Finland 0
France 0
Germany 0
Iceland 0
Ireland 0
Italy 0
Japan 0
Netherlands 0
Norway 0
Portugal 0
Spain 0
Sweden 0
UK 0
United States 530,000

There’s a lesson there.

[ClinOncDoc @ClinOncDoc]

Drs are NOT ‘choosing’ to be out of training

Last year there were 26,000 drs applying to 9,000 training posts

Drs are choosing not to be unemployed so they can put food on the table

On current trajectory most Drs will never become consultants

Dire state of affairs

@gmcuk

[Dr Shivam Sharma @DocShivSharma]

@gmcuk There has been a 201% increase in applications to specialty training but only a 9% increase in posts over the last decade.

Doctors are not "choosing" to go into LE jobs.

Many doctors are now in fact facing unemployment.

This is abysmal workforce planning.

[Ross Prager @ross_prager]

Here are 10 things that expert clinicians do everyday, often without realizing it🩺

(and how we can all start to implement these in our own practice)

A 🧵

#foamed #MedTwitter

[DigiBete @DigiBeteUK]

💥What is Type 1 Diabetes?💥 

Have you seen #DigiBete's animation helping to educate young people and families on what #type1diabetes is? You can watch the full film in your #DigiBeteApp age page or learn more here: 

https://t.co/igoIKCDAs0   

It's also great to share this animation with family, friends and schools to help them understand and raise awareness of what type 1 diabetes is.

#T1D #Diabetes #DiabetesAwareness #GBdoc #Core20plus5 #CommunityLed #ClinicallyApproved #t1dlookslikeme

[Mujeeb Zubair, MD @MujeebZubair]

2.2 liters - massively dilated left atrium !!🫀🫀

Can you guess the cause ?

[Levi Pay @soppystern]

This is @thelizcarr, in 1 minute 30 seconds, summing up perfectly why assisted suicide is a disability rights issue.

[Farrukh @implausibleblog]

Palliative Care Doctor, Dr Rachel Clarke,

"The predicament of those of us who work in palliative care - and I've worked with thousands of patients approaching the end of their life - is that the real world, right now, is one in which palliative care services are failing patients because they're underfunded understaffed"

"Wes Streeting himself admitted this"

"The lack of care might coerce patients into feeling that their only option is to take their life, because we're not giving them a life worth livinG"

[Dr Rachel Clarke @doctor_oxford]

Approx 29k resident doctors applied for 9k training posts this year. They're not "choosing" to forgo specialist training, @gmcuk, they're being forced out of it by the decision to artificially suppress numbers of doctor training posts, even though we're so short of consultants.

[Royal College of Physicians of Edinburgh @RCPEdin]

The College has responded to today’s gmcuk workforce report. Read the full statement from our President @AndrewElder: https://t.co/cMJWFSEwHU

[Prof Kamlesh Khunti @kamleshkhunti]

Real-world study

Veterans with T2 diabetes initiated on SGLT2i (vs GLP1RAs) associated with reduced risk of:

Mortality
Worsening eGFR
Renal endpoints including ESKD
Improved glycemic, metabolic control

https://t.co/H8LEGrAo53

[The BMA @TheBMA]

Today's #StateOfMed report shows a medical training system under severe strain.

There aren't enough training jobs available for resident doctors. This means unprecedented competition for posts, with both UK and IMG medics left to wonder if their vocation is still worth it. (1/2)