Sunday, October 05, 2008
Sunday, September 21, 2008
Thursday, September 18, 2008
Things I don't like about my job...
- from patients
- from other staff
Abuse is abuse, no matter who you get it from, or whatever the background, or how you try to make it ok in your own head, or however much you try to ignore it. Be it threatening behaviour and drug seeking by someone who isn't very nice, to an angry cancer patient still coming to terms with their diagnosis, or a power tripping member of staff.
It still hurts.
2 - Ethical issues
- isolated
- compounded by confidentiality
There is never a 'right' answer. All shades of grey. Never simple. Never straightforward. Whatever course of action you take is going to seriously impact on someone's life.
3 - Constantly being short-staffed, and thus having to work extra long hours, regularly, unpaid, adding to an already packed, stressful day.
It's exhausting. There is only so much a human can do. Mistakes could easily happen. And even if you raise concerns, asking for more help, you end up being told that people have dealt with it before you, so you should be perfectly capable of dealing with it too.
4 - Breaking bad news
No matter how carefully it's given, it's still bad news.
5 - Bland food in the canteen. hrmph.
Monday, September 15, 2008
I've been thinking about this for a while...
1- Given my job, I move around a lot. Come August, I don't know where I'll be in the country (or whether I'll have a job. (eek!)) - I could theoritically work on one for only a year maybe...
2 - I don't know much about gardening - but I could learn
3 - I don't know of any local to me
4 - Not something I want to do alone.
Maybe, one day, I'll settle down in an area, that has an allotment, and discover one of my friends is also interested...
I can always dream...
But until that day...
allotment series- cookery
allotment blog
life on a london allotment
Saturday, September 13, 2008
Wednesday, September 10, 2008
Friday, July 04, 2008
in search of Malaysian food in London
satay house - have teh tarik and nasi lemak, but appears to have no roti!
roti recipe
Tuesday, April 29, 2008
A book medical students and junior doctors should read.
A GP's reflections
quite a good article by Max Pemberton, a junior doctor and telegraph columnist
and another reflecting on change-over time
Sunday, April 27, 2008
recipe: Rose Petal Macaroons
Ingredients:
150 g ground almonds
200 g sugar
2 egg whites
1 tsp rosewater
1 tsp scarlet food colouring
1 tbsp plain flour
20 crystallized rose petals for decoration
Method:
1. Cream ground almonds, caster sugar and egg whites.
2. Add flour, rosewater and colouring.
3. Allow mixture to firm in the fridge for an hour.
4. Flour work surface and hands and roll small amounts of mixture into truffle-sized balls.
5. Flatten balls into rounds and place on a baking tray lined with greaseproof paper.
6. Decorate the centre of each macaroon with a crystallized rose petal.
7. Bake 10-15 minutes in a warm oven (gas mark 3/160C).
8. Allow to cool and harden for 15 minutes.
Saturday, April 26, 2008
These images made me smile.
it's mr angry!
and mr crazy!
and another mr angry!
Saturday, December 15, 2007
Of maps...
Geographical fun, from 1869, had various European countries outlining their national stereotypes of the time accompanied by a little poetry.
A political depiction of 1937 .
Synthetica - new world map of new materials (1940)
And finally, a very charming face map
the museums of London
Which leaves Londoners with even less reason to get bored in their home town.
Saturday, October 27, 2007
real food
the other posts are far more interesting. really.
Saturday, September 01, 2007
newly qualified docs
with more than a few grains of truth.
Monday, August 27, 2007
citroen 2cv
and for those who don't - a little wikepedia explanation.
new version, probably set to come out in 2009/2010.
I don't think I like it. I feel so disappointed.
Sunday, July 29, 2007
Friday, June 29, 2007
Something from Mother Teresa...
Forgive them anyway.
If you are kind, people may Accuse you of selfish, ulterior motives;
Be kind anyway.
If you are successful, you will win some false friends and some true enemies;
Succeed anyway.
If you are honest and frank, people may cheat you;
Be honest and frank anyway.
What you spend years building, someone could destroy overnight;
Build anyway.
If you find serenity and happiness, they may be jealous;
Be happy anyway.
The good you do today, people will often forget tomorrow;
Do good anyway.
Give the world the best you have, and it may never be enough;
Give the world the best you've got anyway.
You see, in the final end,
it is between you and God;
It was never between you and them anyway.
Monday, June 18, 2007
Saturday, June 16, 2007
I think I've just found my favourite new website
Quite a few handy tips.
Friday, June 08, 2007
Just found something that brings back good memories
snoopy and woodstock dancing
It's a mystery, Charlie Brown
Sesame street!
Kermit and the African Alphabet
Subway!
Kermit - put the lime in the coconut!
Never smile at a crocodile=
News flash!
Wolf chases little red riding hood!
Cookie monster..
... in the bakery
then the library
From How Now and the Moo Wave...
The wet paint song
Danger's No Stranger
and from the Surfin' Monsters
Love the Ocean - yeah dude!! be excellent and do what it says!
Not forgetting Little Jerry and the Monotones
Telephone rock!
Mad - yeah we're angry, very very angry
Boo Hoo, Wah Wah, Sob Sob - Big kids cry
Dr Thad and the medications with...
The 10 commandments of health - succinct, accurate, and fun!!
orange singing carmen
Computer cookie song - things really have changed...
Manamana
Wednesday, June 06, 2007
Sad
Monday, June 04, 2007
Friday, June 01, 2007
Thursday, May 31, 2007
Sunday, May 13, 2007
on clouds and free running
the sine wave cloud
Don't ask me about the technical details. They just look funky. Who ever thought cloud watching could be this much fun!
some more parkour, 'cos it's cool.
all very artistic
Sunday, May 06, 2007
I want to make some dandelion root coffee!!!
But I don't know anywhere nearby where I can get some dandelions which a dog hasn't used as a toilet.
Blah.
But if, one day, in the future, I happen upon a place with plenty of fresh (unlikely-to-be-peed-upon) dandelions, I shall be able to refer to these instructions.
mmmm...
oh, and a dandelion profile from the early 1900's for the interested.
Friday, May 04, 2007
Sunday, April 29, 2007
no such thing as a free lunch
The 'no free lunch' position is explained in these websites: (US version and UK version) better than I ever could.
For good evidence:
UK - drugs and therapeutics bulletin
Canada = therapeutics initiative
US - The medical letter
Friday, April 27, 2007
I confirmed a death for the first time today...
I don't want to do it again. But I know I will. I know I will eventually get used to it. I don't know whether that's a good thing.
And so life continues...
Sunday, April 22, 2007
Poem: I AM A GIRL OF THE 21st CENTURY
I close my eyes until the storm is over
Like an eagle I try each day in my life
To reach where my heart is.
Hope that I have inside, to give me
Strength to be what I want to be
I let no one harm my soul
I always focus on my future.
During the night I dream about freedom
During the day I build happiness in my soul
Each day I shape my life.
Trying my very best to do only the right thing.
I am born to be bold and brave
To have faith in everything I do
To help those who are being criticised everyday
To renew hope in their lives.
Even if it may seem to dark
My heart will lead me to a place of Peace.
I am living for tomorrow.
Not for today
Only because
I am a girl of the 21st century
Zandile Sylvia Mazibuko
Wednesday, April 11, 2007
Tuesday, April 10, 2007
For a warm and fuzzy feeling...
Would be nice if every paper did that...
Monday, April 09, 2007
Saturday, April 07, 2007
MMC resignations...
Resignations seem to be propping up left, right and centre. To be fair, those resigning are the ones who were probably doing their best to improve a system. Just a shame it didn't work out.
The latest is from one of the student representatives - his letters are a good read and summary of the situation:
letter of resignation, as sent to Professor Crockard 18/03/07.
Dear Alan,
I am sorry to inform you at what must be an impossibly busy time that I wish to resign from my position as medical student advisor.
When I took the position I had many reservations with the MMC systems but believed that I would be able to help students get the best deal from these changes. Seven months on, I retain these reservations and regret that I have not been able to have the impact I had imagined.Now as then (when I presented you with a petition signed by 1300 students), I believe:
• The nature of the new application system effectively randomises medical students to jobs across the country
• The importance of academic achievement has been downgraded
• The importance of other achievements at medical school has been nullified by the nebulous nature of questions and the lack of a CV
• Two years is not long enough to decide on one’s specialty, to gain a broad enough range of experience, to become a good enough doctor: pressure is on to decide early, but the random nature of the application leaves no scope for strategising or planning ahead
• Morale at medical schools is low; they are not the aspirational, centres of excellence they should be, rather ‘centres of competence’
• This anxiety has filtered down to those students considering applying for a place at medical school
Through contact with a wide range of students over the last seven months, I know that these views are widely held. Just two nights ago, I talked to a Bristol student representing a group of 40 who echoed my above sentiments. I have, however, come to realise that continuing to transmit such views to the MMC team can have no effect as it is focused on the successful implementation of a system rather than the guiding principles and details of that system.
In my limited experience, the role of student advisor is not used, as MMC aspires, to ‘encourage dialogue with the stakeholders’. Instead the role seems to be a token attempt to suggest the involvement of students in MMC strategy; a publicity vehicle to lend validity to a system that has not, in fact, considered student opinion and insight at all.When I was asked recently to find some students / SHOs who were happy with the new system to help build some positive press, I knew this role was not for me. I am not interested in spin or image, in making something seem other than it is. I am interested – perhaps naively - in getting the popular voice heard and acted upon and in standing by my own personal, political and professional principles. I now realise that in order to do this effectively, I need to be working within a different framework.
I would like to thank you for giving me the opportunity to fill the role and personally wish you all the very best for the future. I can honestly say that I have enjoyed meeting you and having the chance to work with you and the team as a whole.
Yours Sincerely,
Alex
letter as sent to the CMO 31/03/07:
Dear Professor Sir Liam Donaldson,
I recently resigned as medical student advisor to MMC.
Despite claims from the health minister that the new Foundation Programme has ‘widely been acknowledged as a success’ there are, and always have been, huge misgivings about it at student, junior doctor and all other levels. I hoped that access to the MMC team would give me an opportunity to make these views heard. I was wrong. Although you continually tell us that you are ‘working with the profession’ you are not, at any level, listening to it. This is why I resigned: please find enclosed my letter of resignation to Professor Alan Crockard.
From a grassroots level upwards, your recruitment of those from the profession has been tokenistic at best. My role was little more than a publicity stunt. You want to be seen to be involving us but care little for the reality of what we actually have to say.Even at the highest levels you have been seen to charge professionals with responsibility but withhold authority.It is not my job to outline the infinite professional, personal and philosophical problems that blight your new systems – the 12,000 junior doctors who recently marched through London could do this more eloquently than I could ever hope to – but it is my job to expose the growing chasm between yourself and the profession.
Your agenda does not meet with the approval of the profession. You must acknowledge this. It is not acceptable for you to enlist members of the profession from all levels and to then ignore them. It is not acceptable to use your implementation team – MMC – as a vehicle for spin, as a way to convince the profession that things are other than they are. It is not acceptable for you to hide behind the responsibility you have dispensed to MMC and at the same time maintain your authority so you can push through your own agenda.
And yet, this is what you are doing. No matter what the profession says, no matter how vociferously it protests, no matter what damage is done to families up and down the country, this is what you will continue to do. How kind of Lord Hunt – at a time when faith in your systems is at its nadir - to illustrate the DoH’s utter contempt for the profession, by saying “I would like to reconfirm our commitment to MMC which aims to recruit and train the best doctors to provide the best possible patient care.”
This is your project. Everyone else – from MMC to MTAS, from the royal colleges to PMETB, from the advisors to the spin doctors – are merely your implementation tools. Ultimate authority rests with you. It is now time for you to take responsibility. If you continue to force through these reforms, I want you to know that it is obvious - even from a medical student level - that you are a million miles away from being the ‘bridge between the profession and the government’ that you claim: you could not be acting more undemocratically if you tried.
If you find this image unappealing, your options are clear: take heed of the groundswell against you and your agenda and cede your authority back to the profession. If this is also unpalatable to you, then you must resign.
Yours Sincerely,
Alex Liakos
(picked up from the lost doctor)
more news on mmc
Friday, April 06, 2007
Poem: SONG OF THE GALLEY-SLAVES
Will you never let us go?
We ate bread and onions when you took towns, or ran aboard
quickly when you were beaten back by the foe.
The Captians walked up and down the deck in fair weather
singing songs, but we were below.
We fainted with our chins on the oars and you did not see
that we were idle, for we still swung to and fro.
Will you never let us go?
The salt made the oar-handles like shark-skin; our knees
were cut to the bone with salt-cracks; our hair was stuck
to our foreheads; and lips were cut to the gums, and
you whipped us because we would not row.
Will you never let us go?
But, in a little time, we shall run out of the port-holes as
the water runs along the oar-blade, and though you tell the
others to row after us you will never catch us till you
catch the oar-thresh and tie up the winds in the belly of the said. Aho!
Will you never let us go?
Rudyard Kipling
Friday, March 30, 2007
Wednesday, March 21, 2007
Monday, March 19, 2007
Sunday, March 18, 2007
Poem: I love me mudder
we come so far from over de sea
we heard dat de streets were paved with gold
sometime it hot sometime it cold,
I love me mudder and me mudder love me
we try fe live in harmony
you might know her as Valerie
but to me she is my mummy.
She shouts at me daddy so loud some time
she stays fit and she don’t drink wine
she always do the best she can
she work damn hard down ina England,
She’s always singing some kind of song
she have big muscles an she very very strong.
she likes pussy cats an she love cashew nuts
she don’t bother with no ifs and buts.
I love me mudder and me mudder love me
we come so far from over de sea
we heard dat de streets were paved with gold
sometime it hot sometime it cold,
I love her and she love me too
and dis is a love I know is true
my family unit extends to you
loving each other is the ting to do
Benjamin Zephaniah
Saturday, March 17, 2007
Tuesday, March 13, 2007
Poem: the caged bird in springtime
This curious anxiety?
It is as if I wanted
To fly away from here.
But how absurd!
I have never flown in my life,
And I do not know
What flying means, though I have heard,
Of course, something about it.
Why do I peck the wires of this little cage?
It is the only nest I have ever known.
But I want to build my own,
High in the secret branches of the air.
I cannot quite remember how
It is done, but I know
That what I want to do
Cannot be done here.
I have all I need –
Seed and water, air and light.
Why then, do I weep with anguish,
And beat my head and my wings
Against those sharp wires, while the children
Smile at each other, saying: “Hark how he sings”?
James Kirkup
Monday, March 12, 2007
Poem: War
not a good habit at all
climbing unknown walls is hazardous
because the wall might fall.
If you walk down the street be the walk quite brisk
you and I know you’re taking a risk.
And if de same time you feel your belly start to swell
chances are you eat too well.
One could dream about a life of peace
one can try to bring peace to the beast.
Everybody seeking some utopia
what we need is the will to come over.
War is a danger to your health
don’t care if you have much wealth.
War is a dangerous ting,
even if you’re not partaking.
Workin’ on a building site is cruel
you take a risk if you ride on a mule
if you walk on the left and you see one fight
the best ting to do is walk on the right.
Racin’ driving is a serious business.
Be careful of your liver if you drink too much Guinness
and if you live on LSD
blame nobody if your mind don’t free
all we hear is war, more war
I and I know that can’t get far
just because dem live in the West
dat don’t mean dey is de best.
War is badder dan cigarettes
war is worse dan racin’ driving
remember dis and don’t forget
World War Three means no surviving.
Unity is a strong foundation
love is better than fear
what we need now is good relations
as politicians don’t care.
So I talk to the young and old
come take a peaceful stroll
don’t care if you have much wealth
war is a danger to your health.
War is a dangerous ting,
even if you’re not partaking
just smoking
not partaking.
Benjamin Zephaniah
International journal of epidemiology
Published in The Dread Affair. Arrow Books 1985.
Sunday, March 11, 2007
Poem: You wake up in the morning
with twenty-four hours of the magic tissue of the universe of your life.
No one can take it from you. No one receives either more or less
than you receive. Waste your infinitely precious commodity as much as you will, and the supply will never be withheld from you.
Moreover, you cannot draw on the future. Impossible to get into debt.
You can only waste the passing moment. You cannot waste
tomorrow; it is kept for you.
Arnold Bennett
Saturday, March 10, 2007
a charming new animation
But no. I'm grown up now. And come home late. Blah.
CBBC behind the scenes
Tuesday, March 06, 2007
MTAS and West Midlands deanery pulling out of the system
"The ST3 Interview Panel for General Surgery in the West Midlands have unanimously come to the conclusion that the MTAS procedure for recruitment to ST3 in General Surgery, has not been implemented according to agreed guidelines.
We have therefore declined to continue with the interviews today.We have come to this conclusion after considerable debate. We feel that this is the right course of action, which has at its heart the best interests of surgical trainees, training and our patients.
A serious procedural flaw, which came to light this morning, has been the complete lack of a longlisting process prior to selecting candidates for interview. This alone is sufficient grounds for postponement or cancellation and makes the entire recruitment process open to criticism and challenge.
Our meeting at 8.00 am today was the first available reasonable opportunity for the panel members to meet, discuss the process and air their concerns and reservations. With the limited information available today on-site, the longlisting process could not be completed satisfactorily. In addition we feel that the recruitment process for ST3 in its current format is in contradiction to equal opportunities legislation and NHS best practice guidelines.
We have in addition, wider concerns about the current MTAS process as follows,
As far as we are aware, the shortlisting application form has not been validated or demonstrated to be suitable for appointments to ST3 in General surgery which in effect is a pre-consultant appointment.
The application form domains available to the shortlisters and its accompanying scoring system have not been shown to select candidates best suited to be surgeons. It fails to distinguish adequately between candidates, giving credibility to creative writing skills rather than hard evidence of competency.
The time-scale imposed nationally has ensured that the whole process has been rushed. The unrealistic deadlines and sheer number of applications caused the MTAS computer system to crash. Changes in process have been implemented in order to meet deadlines. The marking system for shortlisting has been inconsistent throughout the country with forms being marked by a varying combination of members of the medical profession and lay people. There has been a lack of cross validation between markers and different marking methods (horizontal and vertical) have been used in different deaneries. Therefore there has been no standardisation or quality control.
The staff in the West Midlands deanery have worked tirelessly without adequate resources in place to try to meet the deadlines set. This has meant working holidays and weekends repeatedly entering marks onto an unreliable MTAS Website. They have finally provided a shortlist of candidates for ST3 in General surgery on the Friday evening prior to the Monday morning interviews. In all, the deanery has received 11500 applications, well in excess of the projected 8000.
We owe it to our patients and the profession that we are able to select and appoint the best candidates to surgical training posts and felt strongly that this was impossible today.
We have agreed to return to help re-shortlist and interview once the entire process has been proved to be reliable, robust, reproducible and has been validated and agreed upon nationally.
Above all we have carefully considered the plight of the candidates outside today, waiting to be interviewed. We have stayed and spoken to all the candidates about our decision with honesty, openness and integrity. We have been at pains to assure them of our best intentions towards trainees and surgical training as a whole. We share their concerns and the concerns of the hundreds of other young doctors who haven’t been shortlisted for any job. We share their anxieties at a system, which is being described and unjust and unfair. We have been overwhelmed by their positive responses to our action and are humbled by their words of support. We have provided support for all the candidates with the offer of contact email and telephone numbers if they require any further assistance."
Monday, March 05, 2007
Sunday, March 04, 2007
the joys of MTAS
All very reassuring. hrmph.
I am not generally a reader of the telegraph, but here's their story.
a doctor dealing with the system.
the questions for the final year application form for first job (points in brackets). 150 words each. The questions themselves at first glance don't seem so bad. But attempting to answer them was a nightmare. There was also no mark sheet, so you didn't know what was wanted. And the total result was given - not a breakdown - so you can't figure out where you went right, or wrong. Slightly frustrating to say the least.
1 - Give an example of a non-academic achievement explaining both the significance to you and the relevance to foundation training. (6)
2 - List your academic achievements (4)
3 - Describe an example (not necessarily clinical) of a time when you had to deal with pressure OR overcome a setback/challenge. What did you do and what was the outcome? (6)
4 - Describe an example from your clinical experience where your behaviour enhanced the experience of the patient as the central focus of care. What did you do and what was the outcome? (6)
5 - Describe an example from your own experience (either clinical or non clinical) that has increased your understanding of the importance of team working. What was your role and contribution to the team? (6)
6 - Describe an example of how your organisation and planning skills have contributed to a significant personal achievement in the last five years. What did you learn from this which is relevant to foundation training?
6 - Describe an example of a situation where you had to demonstrate your professionalism and/or integrity. What did you do and what was the outcome?
Anyhoo, better get on with some work.
lunar eclipse
Eastern Canada - with pic
another...
and one more
and I'm off to take some photographs...
Saturday, February 24, 2007
The autumn windows scene
Monday, February 19, 2007
Friday, February 16, 2007
Thursday, February 15, 2007
Quoth the server, "404!"
'It is said, "To err is human,
"To quote from alt.times.lore,
Alas, you've made an error,
So I must say, "404."
Double-check your URL,
As we all have heard before.
You wanted a file that wasn't there
And I respond, "404."
You may have made a typo--
Your fingers may be sore.
But 'til you get the location right,
You'll just get 404.
Maybe you followed a bad link,
Surfing some foreign shore;
You'll just have to tell that author
About this 404.
I'm just a lowly server
(that speaks in metaphor),
So for a request that I don't know,
I return 404.
Be glad I'm not a mainframe
That might just dump its core,
'Cause then you'd get a ten-meg file
Instead of 404.
I really would like to help you,
But I don't know what you're looking for,
And since I don't know what you want,
I give you 404.
Remember Poe, insane with longing
For his tragically lost Lenore.
Instead, you quest for files.
Quoth the server, "404!"
With apologies to Edgar Allen Poe '
A nice change methinks. Don't know the author...
Wednesday, February 14, 2007
Saturday, February 10, 2007
Poem: Jabberwocky
`Twas brillig, and the slithy toves
Did gyre and gimble in the wabe:
All mimsy were the borogoves,
And the mome raths outgrabe.
"Beware the Jabberwock, my son!
The jaws that bite, the claws that catch!
Beware the Jubjub bird, and shun
The frumious Bandersnatch!"
He took his vorpal sword in hand:
Long time the manxome foe he sought --
So rested he by the Tumtum tree,
And stood awhile in thought.
And, as in uffish thought he stood,
The Jabberwock, with eyes of flame,
Came whiffling through the tulgey wood,
And burbled as it came!
One, two! One, two! And through and through
The vorpal blade went snicker-snack!
He left it dead, and with its head
He went galumphing back.
"And, has thou slain the Jabberwock?
Come to my arms, my beamish boy!
O frabjous day! Callooh! Callay!'
He chortled in his joy.
`Twas brillig, and the slithy toves
Did gyre and gimble in the wabe;
All mimsy were the borogoves,
And the mome raths outgrabe.
Lewis Carroll
and a jokey version:
Chemowocky
'Twas Boron, and the Silicon
Did Carbon in the Cadmium;
All Merc'ry were the Lanthanides
And the Molybdenum.
"Beware the Hydrogen, my son!
The teeth that bite! The chops that chum!
Beware the Bismuth bird,
and shunThe dread Beryllium!"
He Gold his Cobalt blade in hand,
Long time the Fluorine foe he Zinc,
Till rested he by a Krypton tree
And Strontiumed to think.
And as in Argon thought he stood,
The Hydrogen, with Iodine,
Came Radon through the Tungsten wood
And Sulfured Astatine!
One two! one two! and through and through
The Cobalt blade went Scandium!
He left it dead, and with its Lead
He went Gallium back.
"And hast thou slain the Hydrogen?
Come to my arms, Antimony!
O Copper morn! Neon! Xenon!"
He Nickeled in his glee.
'Twas Boron, and the Silicon
Did Carbon in the Cadmium;
All Merc'ry were the Lanthanides
And the Molybdenum.
Mark Stewart