Ahmed

The admission process of a patient in the NHS I am going to use an example of community acquired pneumonia and then stable chest pain as an example to explain the admission process of a patient. I have used medicine as an example just because I know this pathway well ( please note that this may differ from trust to trust and from specialty to specialty). This is to give you a general idea.  PRIMARY CARE (General Practice- GP) https://www.healthcareers.nhs.uk/explore-roles/doctors/roles-doctors/general-practitioner-gp/general-practice-gp https://www.nhs.uk/nhs-services/gps/ These healthcare professionals provide consultations for patients who are relatively stable. For example, if I develop a cough and am bring up yellow phlegm, have a fever but do not feel very breathless, I will call my GP and arrange an appointment. They will assess me and then decide whether this warrants antibiotics. They will then get me a prescription and I will collect it from my local pharmacy ( https://www...

This post is all about discharge summaries. These are also called: TTO - to take out  TTA- to take away  EDN- Electronic discharge summary  IDS- Immediate discharge summary  And you will get sick and tired of hearing this term day in and day out when you are working on a ward! However these are very important as: 1. The patients GP is notified about the patients admission and what happened 2. Any investigations the GP needs to do, any medications they need to review  3. The patient gets a copy so that they ( and their carers) know what happened in hospital and if there are any changes to their medication  4. If the patient has any outpatient follow ups.  5. If the patient goes to another trust which does not have access to the system of your trust, the discharge summary ( which is printed out and given to the patient) is what will relay all the information.  Every trust has their own IT system and after working in 5 trusts, I really struggle when ...

This post is about post take ward rounds. As I am a medical registrar, I am going to stick to medicine using examples however this can be used in any specialty.  In medicine ( and most specialties), patients are admitted via 1. Emergency to the acute medical unit/ elderly assessment unit 2. Directly to the acute medical unit from GP surgeries  3. Directly to specialty wards from clinics These patients are then 'clerked' by doctors, ACPs/ANPs, physician associates who: 1. Take a history  2. Examine the patient  3. Request relevant investigations  4. Make a management plan  I have mentioned more on this here: How to clerk patients safely and efficiently:  https://omarsguidelines.blogspot.com/2019/08/how-to-clerk-medial-patients-safely-and.html Once the patient has been clerked, they are for post take. The post take consultant usually has a doctor(s) with them who scribes/requests relevant investigations.  The consultant goes through the patients cle...

This post is about observing your colleagues when you start working in the NHS in your first job. We all have the clinical knowledge. All we need is the '' Logistical Knowledge'' like  - How to document  - How to do ward rounds  - How to chase jobs  - How to prioritize jobs  - Cannulation equipment   - How to make referrals  - How to make discharge summaries  And the list goes on...  I have made a few blog posts on this here: https://omarsguidelines.blogspot.com/ And my colleagues have shared their experience and advice in the blogs here: https://naseersjourney.com/useful-links/ But despite all of this, we still need to actually observe these things we can easily read on blogs/websites.  A lot of IMGs struggle with settling into their first jobs in the NHS for this reason.  Plus the HR and management does not help. The reason being: 1. They assume that you have prior NHS experience  2. You have not asked hence they do not ...

Read the guidance here: https://www.gmc-uk.org/registration-and-licensing/join-the-register/before-you-apply 1. Medical school  Ensure your school is the world directory.  The link is mentioned here: https://www.gmc-uk.org/registration-and-licensing/join-the-register/before-you-apply/acceptable-overseas-qualifications/qualifications-not-listed-in-the-world-directory-of-medical-schools Give BSC English (if possible- not a requirement) before graduation. Pre-graduate degrees get you more points in your interviews when you apply for training posts in the NHS.  Please note that this is not a requirement and you should not worry if you cannot get it. I personally do not have it and I know a lot of other colleague who do not have it either yet we all got into training posts easily.  2. House job (one year internship) Ensure this is according to the guidance here: https://www.gmc-uk.org/registration-and-licensing/join-the-register/before-you-apply/check-if-your-practical-tr...

Before I start, I want to dedicate this blog post to my pillar of support - my wife: Tayyaba Aizaz without whom I would not be at this stage. I am a trainee registrar in acute internal medicine. I came with my wife in January, 2016 and started as a non trainee SHO.  I got a job as a core medical trainee ( Now replaced by IMT) in my deanery of choice and joined in August, 2017.  We had a daughter when I was a core medical trainee year 1.  I got 2 weeks off as paternity leave.  Luckily, our families were here so they supported us a lot.  I am now a ST5 trainee in acute internal medicine and I have been looking back at all these 3 years - my daughter is growing up fast! She is going to pre-school and will be starting school from next year. My focus in life is to ensure I spend the maximum time with her, no matter what.  And although my specialty seems to be very tough, it is not.  My work hours are usually 0900 to 1700 /0800 to 1600 and on calls whic...

Some IMT 3 colleagues have contacted me to ask what they should expect in acute medicine as a 0800 to 1600 regular job as part of their 3 or 4 month placement as a registrar. Se DGHs are not used to having a registrar on AMU and consultants have no idea. I am working as a ST5 registrar in acute internal medicine and had two 4 month placements in acute medicine and this was my rota                              MY ROTA ( TEACHING HOSPITAL) Every week Day one 0800 to 1600 on AMU My job description 1. Attend handover at 0800 am 2. The consultants then ask me to see patients who have already been post taked from the past few days and I do senior reviews 3. I do any procedures like LPs, drains , etc 4. I help other colleagues with difficult cannulas , ABGs, etc 5. I am usually done by noon. 6. I am free for most of the afternoon and help with - discharges - clerking And I always leave on time at 1600. Sometimes the con...