House Officer

I'm the least in my clan. Outsiders see me as a god, but within my clan,I do the house chores. The itsy-bitsy work I do saves lives. #MedicClan👨🏼‍⚕️👩‍⚕

[House Officer @hjChronicles]

House officers are unsung heroes. We do the "itsy-bitsy" work that save lives. We deserve better working conditions and good remunerations. We hope this is rectified in no time.

[rae_timzy @omo_Akinbile]

A day in life of an olodo🥲

[𝐃𝐫 𝐁𝐢𝐬𝐡𝐨𝐩 @DrJohnBishop]

God,
I trust You

When everything around me falters
I trust You
When I travel by road, sea or air
I trust You
When there’s no money in my account
I trust you

When I feel sick in my body
I trust You
When I struggle with low mood
I trust You
When my kids are feeling ill
I trust You

When I fail an examination
I trust You
When jobs seem to pass me by
I trust You
When my business doesn’t turn profits
I trust You

When friends betray me
I trust You
And even when my family disappoint me
I trust You
Especially in the presence of enemies
I trust You

I TRUST YOU LORD!

Say this prayer with faith and repost to bless everyone.

#Bishopsprayers

[GMC @gmcuk]

PLAB 1 update

On Thursday 14 March 2024, we’ll release PLAB 1 places for 20 February 2025 in all locations

On 12 February 2024, we’ll also make some additional places available for 8 August 2024 and 7 November 2024 in Accra, Islamabad and Karachi. We’re doing this because both locations sold out quickly during our last release, while other locations still had availability after the release.

[Kunle @Soulmedika]

Following the space session on “Financing your PLAB journey”; there are doctors practicing in the UK willing to invest some of their money into a Trust Fund to help doctors fund these exams, of course as a form of investment.

However, we have not been able to come up with modalities of operation. That remains the Elephant in the room.

[Dami @damilola_MD]

**Post quota implementation**

Patient: Get’s admitted by 4:02pm.

Medical students by 4:03pm hustling for the same patient 👇🏿

[Dami @damilola_MD]

Gastroenterology consultants when they come for ward rounds and see 50 students attached to them. “50 causes of Upper GI bleeding” go finish today. https://t.co/WxH5dCfE5J

[rae_timzy @omo_Akinbile]

A friend in need is a friend indeed, sometimes

[House Officer @hjChronicles]

Japa 2.0

[Dr Pepple @drpepple_]

Many IMGs japa destination is UK or America.
Going these places are becoming very expensive for doctors.

You can consider going to Saudi, Dubai, Malta, South Africa or any other country that pays doctors more than your county.

You can raise money from there to fund your dream japa country.
Even inside japa, there’s another japa😀

[Dr Pepple @drpepple_]

Many IMGs japa destination is UK or America.
Going these places are becoming very expensive for doctors.

You can consider going to Saudi, Dubai, Malta, South Africa or any other country that pays doctors more than your county.

You can raise money from there to fund your dream japa country.
Even inside japa, there’s another japa😀

[𝐃𝐫 𝐁𝐢𝐬𝐡𝐨𝐩 @DrJohnBishop]

No matter how strong you are alone; you are stronger in the company of other strong people.

Make affiliations with likeminded people and those that will elevate your trade and beliefs.

Never has a single tree been able to make a forest. Nobody is that special to change this.

[𝐃𝐫 𝐁𝐢𝐬𝐡𝐨𝐩 @DrJohnBishop]

As a registrar in an emergency department, I have found out that a lot of Nigerians in the UK struggle to properly access health services in the UK.

A lot of our people don’t know how to use 111, when to call 999 and when to see their GPs.

Some wait in the ED for hours when they could have easily gotten an over the counter medication.

A lot don’t also understand when their actions or inactions constitute a safeguarding risk for their children.

I will be giving a talk on these via the Nigerian Doctors in UK on the 17th of February 2024.

There will be other aspects of the forum like:

To discuss the process of moving with family and adapting to life in the UK.

To facilitate informal Q&A sessions with experienced professionals.

To create a supportive platform for networking and knowledge sharing.

To introduce junior doctors to the UK healthcare system and its practices.

To explore the essentials of managing unwell patients in a UK clinical setting.

To provide practical tips and advice for a smooth transition to UK practice.

Please repost for the benefit of those that are new in the UK.

Registration is FREE via this link below:

https://t.co/inuPmTASU1

[Dr Pepple @drpepple_]

Join us now https://t.co/J5kAlCcGhB

[Dr Pepple @drpepple_]

30 Day PLAB 1 PLAN:

Day 1: 50-100 Sample MCQs - to familiarise with exam pattern.

Day2:
CVS
•Chest pain
•Fatigue
•Heart murmur
•Hypertension
•Palpitations
•Peripheral arterial disease
•Peripheral edema, breathlessness.

Day 3:
Neuro
•Blackouts and faints (funny turns) 
•Cranial nerve problems
•Falls
•Headache
•Movement disorders including tremor and gait problems
•Peripheral nerve problems and abnormalities of sensation
•Seizures
•Speech and language disorder
•Weakness and fatigue.
•Peripheral nervous system.

Day 4 & 5:
Mental Health
•Alcohol and drug use disorder and dependence
•Anxiety
•Deliberate self-harm
•Eating problems
•Learning and communication problems
•Medically unexplained physical symptoms.
•Mood (affective) problems
•Confusion
•Personality and behavioral disorders
•Psychosis
•Legal frameworks

Day 6:
Blood Gases
•Acid-base imbalance and blood gas abnormalities.
•Electrolyte abnormalities
•Review of CVS/MH/Neuro.

Day 7:
MCQs with Group discussion

Day 8:
Blood and lymph nodes:
•Abnormal blood sugar
•General endocrine disorder
•Thyroid abnormalities
Breast
•Breast lump and/or pain

Day9:
Child health
•Congenital abnormalities
•Developmental problems (Physical, Psychological, and social)
•Failure to thrive (Physical, Psychological, and social).

Day10:
Digestive
•Abdominal mass
•Abdominal pain
•Anorexia and weight loss
•Facial pain and swelling
•Jaundice
•Lower GI symptoms
•Upper GI symptoms
•Nutrition

Day 11:
Endocrine
•Abnormal blood sugar
•General endocrine disorder
•Thyroid abnormalities

Day 12:
Infectious Disease
•Hospital-acquired infection
•Serious infection
•Travel medicine and tropical infections
•Viral infections

Day 13:
Review Endo/Digestive/Childhealth

Day 14: MCQs & Group Discussion

Day 15:
ENT
•Earache
•Hearing problems
•Hoarseness and/or stridor
•Nasal symptoms
•Vertigo

Day 16:
Eye
•Eye pain
•Orbital swelling
•Red-eye
•Visual impairment

Day 17 & 18
Skin
•Bites and stings
•Bullous 
•Dermatological manifestations of systemic disease
•Extremes of temperature
•Hair and nail problems
•Itchy and/or scaly rashes
•Infections
•Lumps
•Moles and pigmented lesions
•Ulcers

Day 19:
Ethics and Professionalism
•Drawing from GMC explanatory guidance
•Drawing from Good medical practice (2013) Duties of a doctor

Day 20:
Respiratory
•Breathlessness
•Chest pain
•Cough and hemoptysis
•Wheeze/ Stridor

Day 21: MCS & Group Discussion.

Day 22:
GUS
•Urethral discharge
•Vaginal discharge

Day 23:
Reproductive Medicine
•Contraception
•Fertility problems
•Normal pregnancy and care
•Problems in pregnancy including bleeding
•Irregular vaginal bleeding
•Cervical smear/ colposcopy
•Pelvic mass
•Pelvic pain
•Vulval and vaginal lumps/lesions
•Prolapse
•Urinary incontinence

Day 24:
Urology
•Groin/scrotal pain and/or swelling
•Urinary tract obstruction
•Abnormalities of the urine
•Urinary symptoms (UTI & Prostatic cancer).

Day 25:
Renal
•Abnormalities of the urine
•Renal problems
•Urinary excretion

Day 26:
Older Adults
•Confusion
•Symptoms of terminal illness

Day 27:
Pharmacology
.Clinical pharmacology (Antimicrobial stewardship, Prescribing safety).

Day 28:
MCQs and Group discussion.

Day 29:
MSK
•Back and neck problems
•Connective tissue disorders
•Foot and ankle problems
•Hand and wrist problems
•Hip problems
•Knee problems
•Rheumatological problems
•Shoulder/upper limb problems
•Skeletal problems including fractures

Day 30:
Seriously ill patients
•Collapse
•Fever/ Infection
•Multiple trauma
•Shock
MIXED BAG MCQS
Include ECGs and photos of spot diagnosis.

[Sam Ghali, M.D. @EM_RESUS]

As a new Emergency Medicine attending 10 years ago I was asked to write about my insights into what it's like to be an ER Doctor. I just randomly came across it and after all these years I'm amazed by how much this all still rings true in my heart today. So I wanted to share it with you guys. Here's what I wrote:

MAKE THINGS HAPPEN, SAVE LIVES, ALLEVIATE SUFFERING

My Emergency Department is a battlefield. Volumes are high and the pace is fast. To succeed as an Emergency Physician I must be an expert of efficiency. I also must be an expert of triage. I am constantly triaging and re-triaging as things evolve. The ED is highly unpredictable. My entire shift I am on guard and ready for any emergency to come flying through the doors at any moment. In the meantime I am either taking care of or seeking out other emergencies. My job is not to be expert in all of medicine. My job is to be jack of all trades and master of diagnosing and treating what can and will kill you. If I cannot provide the definitive care you need, my job does not end until I have gotten you there.

The more I practice Emergency Medicine, the more I realize that what I do more than anything else is - make things happen. Cliff Reid (@cliffreid) delivered an excellent SMACC talk on making things happen in the resuscitation bay. (If you haven’t yet heard it I recommend you do). I’ve come to realize that this concept extends beyond the resus bay and pervades all aspects of my job.

So what does it mean to make things happen? Making things happen means putting my visions of what needs to happen into motion and making them reality.

In order to make things happen, I must first appreciate that my ED is equipped with an army of highly skilled staff that are the heart and soul of the department – and that without them I could make very little happen.

Making things happen means identifying a sick patient and getting them quickly moved to a critical bed; it means getting my suspected head bleed patient expeditiously to the CT scanner with least possible delay; it means mobilizing help to intervene on my flash pulmonary edema patient in hypertensive crisis and getting her on CPAP & Nitro immediately to pull her out of the water and prevent intubation; it means convincing my adamant patient who is ready to walk out the door but is clearly not well enough to go home not to sign out against medical advice, but rather to stay in the hospital where he/she is safe and taken care of; making things happen means advocating for my patients and convincing my consultants to take them emergently to the cath lab or operating room at 3 AM when it otherwise would not have happened until morning. Making things happen means constantly thinking two steps ahead. Making things happen is an art. I have learned that to excel in Emergency Medicine I must master the art of making things happen.

If my goal is to save lives, I must first recognize that a life needs to be saved – that is, I must be an expert at diagnosing life-threatening processes. The 75-year-old clutching his chest with tombstones on his ECG – that’s easy. The problem is that most of my patients are not truly sick. Some are here because they are afraid that they are sick, and just need reassurance. Some are here just for pain medications. Most of my patients are undifferentiated. Sickness is a spectrum. Truly sick patients often look sick, but often they do not. I must be expert at sifting through the crowd and identifying which patients are harboring a life-threatening diagnosis. This is not always an easy task, but it’s up to me to figure it out.

It’s my job to figure out that the 45-year-old gentleman who looks comfortable sitting up in bed watching television and texting on his phone has a Type A Aortic Dissection. If I simply get two sets of cardiac enzymes, repeat an ECG and discharge him home since these are normal – there is a good chance he will die. It’s my job to figure out that the 60-year-old lady with chest pain who was transferred to me for “NSTEMI” actually has a huge saddle pulmonary embolus. It’s not enough to just admit her to the hospital floor only for her to sit up there, decompensate, and have a bad outcome. I have to do better than that. In the Emergency Department, there are landmines scattered everywhere. It’s my job to find the landmines.

I can’t talk about saving lives without talking about Resuscitation. This is an entire topic in and of itself and I could write all day about it – but I won’t do that here. I will simply say that if I want to save lives, I must be an expert at Resuscitation. I believe that as an Emergency Physician, if I am not expert at Resuscitation – my purpose is lost and my mission is in vain. Resuscitation encapsulates those moments that matter most; the moments that often determine my patients’ fates, and define Emergency Medicine as a specialty. Resuscitation is the essence of Emergency Medicine.

In the end, Emergency Medicine is all about the patients. While patients are under my care, I consider them family. When I walk into a room, I shake hands with each patient and all their friends and family members who have come to support them. I look my patients in the eyes. I listen to them. I try my best to put myself in their shoes and empathize with them. I know that communication is vital and I make sure we are on the same page, and that all of their questions have been answered. I make a point to ensure that they know to let me know if they need anything. If my patients are not comfortable, I am not comfortable.

Some humble advice I have to offer for success in Emergency Medicine:

1. Never stop learning. There’s too much out there to know, and knowledge is the foundation for the care we provide. Your eyes won’t see what your mind doesn’t know. Never get complacent in your knowledge.

2. Trust your instincts. Gestalt is at the heart of what we do. Without it we are merely computers and robots. Gestalt trumps any clinical decision rule any day. Even if you don’t know exactly what’s wrong with your patient, but you have a feeling something bad is going on – trust it and pursue it.

3. Be decisive. I’ve seen too many times patients crash while “decisions were being made”. If you choose not to intervene that’s fine, but not intervening should never be the default decision, as a result of indecision. That is unacceptable. First do no harm, does not mean do nothing. Don’t fall victim to being more comfortable with the devil you know than the devil you don’t. Understand that sometimes not taking a risk can be extremely risky.

4. Learn to control your mind in stressful situations. Adrenalinization is normal. While it’s a natural reaction and will enhance your performance, too much will impair your thought process and technical skills. Learn to recognize when you’re becoming over-adrenalized, and learn whatever it is that works for you to be able to relax, stay calm, and temper your sympathetics.

5. Be cognizant of human factors. So much of what we do is psychological. Be aware of your susceptibility to cognitive bias. The key to conquering cognitive errors is to be aware of their existence.

6. Debrief after codes or tough cases and take time to reflect back after shifts. I do this routinely and I find it to be invaluable. Some of the greatest things I have picked up on have been via this process.

7. Learn Emergency Ultrasound.Believe me when I tell you that Emergency Ultrasound will transcend your practice. If you don’t learn EM ultrasound, at least learn the critical care stuff. If you don’t learn the critical care stuff, at least learn basic Echo – it has the greatest impact.

8. Follow up on your patients. I can’t express how much of my learning is through following up on my patients. If you don’t do it already – start! You will be amazed by how much you will learn.

9. Accept and embrace that some of your patients will have bad outcomes or die no matter what you do – but never, ever let this be an excuse to provide anything less than the best care you possibly can.

10. Be kind and compassionate. When it’s all said and done our patients may not remember details of their ED stay during what might very well have been the worst day of their lives – but they will remember how we made them feel.

[Kunle @Soulmedika]

PLAB journey in Naira!!!!!😳😳

-IELTS = 107,000

-PLAB 1 £255 = 433,500

-PLAB 2 £934 = 1,587,800

-PLAB 2 Academy;
.Samson £600 = 1,020,000
.Keypoint 450 = 765,000

-EPIC verification ~£250 = 425,000

-Visitors visa £115 = 195,500

-PLAB House/Hotel Accommodation for 10 days £250 = 425,000

-PLAB 2 Return Flight tickets (Average for BA) £1000 = 1,700,000

-GMC Registration;
. Within 5yrs of graduation £161=273,700
.More than 5yrs of graduation £420 =714,000

-Tier 2 Visa Application £247 (per individual, if you have a partner and Child(ren) multiplied by the no ) = 419,900

-One way Flight ticket to the UK (Average for BA) £400 = 680,000

-First month UK shared apartment rent ~500 = 850,000

-Police clearance ?
-TB test ?

I can’t even sum it up😳😳

[rae_timzy @omo_Akinbile]

I present to you🫴🏻🫠

[Dr Pepple @drpepple_]

PLAB 1 PREPARATION:

Now that you’ve booked your PLAB 1 seat, it’s time to start preparing for the big exam.
Here is how:

1.UNDERSTAND WHAT IS EXPECTED OF YOU AND TRY TO COVER IT.
•Before you settle to study for PLAB1, understand the Curriculum. Check out my 30/60 days PLAB 1 PLAN on twitter here.
It gives you a sense of direction so you can prioritise.
•Join the PLAB group on Facebook.

2.DEVELOP A STUDY ROUTINE •CHOOSE YOUR PRODUCTIVITY SPACE, Your happy place to study. You can study alone or in a group and get accountability partners.

3.DEVELOP A STUDY PATTERN Using the ACR method-
•Accumulating info >Conceptual understanding of the topics>Recall-active recalls/revision and use of question banks. Check my YT for video on this. https://t.co/pitJl6rqte

https://t.co/T2J4kti5Vq MATERIALS:
•PLAB 1 Keys- just like summary notes.
•PLABABLE- Get the online subscription one because the info are always updated.

•Read topics from PLAB 1 keys and solve questions using PLABABLE.
Always read the explanations of any question you solve.

•Do some MOCKS/Academy Big Mocks

ADDITIONAL RESOURCES:
•SamsonPLAB notes.
•Online question banks: Either of Medrevision, Pastest, inspiremedics (free version), arora, emedica.
OHCS/OHCM/www.patient.Co.uk, NICE guidelines.

6-8hrs study every day will get you ready for the exam in 60 days.

Recent Plabbers, what materials did you find useful in your prep? Share so others can learn.

Follow , repost, and comment for more educational contents.

[Dr Pepple @drpepple_]

In this video, we discussed working conditions in the U.K. for doctors that most people don’t usually talk about.

ALL YOU NEED TO KNOW AS A NEW DOCTOR IN UK //IMG WEBINAR https://t.co/RLWON6f6fp via @YouTube

Watch. Share. Comment. Subscribe to my channel

[House Officer @hjChronicles]

Food Science...😆😆

[Dr Pepple @drpepple_]

DELAY IN GETTING DOCTOR JOBS IN U.K.

Last week I had a chat with a young doctor who was getting frustrated with waiting to get NHS job 3 months post-GMC registration. I shared my journey and it lightened his mood.

Listen, it might take a little longer to get job in the NHS as a doctor but that doesn’t mean there are no jobs.
The NHS desperately still needs IMGs to fill up positions. Review your CV and Keep applying.

Sometimes, if there’s delay in getting training job(residency), stay on your non training NHS or private hospital jobs for a while. I spent 2 years doing non-training jobs to finally decide on specialty training. It’s not a stagnant period, it’s a learning and earning time.

You can apply for clinical observerships positions if you can afford the expenses of working without pay. Those 2-4weeks will afford you experience and references that might help in getting a job locally, faster.

Lastly, lean on to mentorship. Mentorship inspires confidence in you, helps you avoid mistakes and adds speed to your journey.
Best wishes.