Segun Olusanya (He/Him)

Understanding lung physiology through ventilator screen
🫁 airway pressure waveform: equation of motion, conductive P, stress index, DP
🌊 flow waveform during PCV
💨 expiratory flow/time constant
🛌 dynamic bedside maneuvers: AOP, recruitability & recruitment-to-inflation ratio
#FOAMcc
🔓 rdcu.be/e6iG6

Thea Stein at the Nuffield Trust Summit: "An NHS Chief Exec I spoke to said the most morally distressing things they did were to manage NHS money – but I couldn’t publish that as it would identify them. By the sixth one who said that, I knew it wouldn’t." Watch the livestream via the link in our post.

@theasrstein.bsky.social shares the reality of being an NHS leader today, as part of a packed #ntsummit programme.

Watch the livestream and look out for the recordings on our website 📽️

👉 buff.ly/9RtiYiq

As heard elsewhere (I paraphrase);

Improv works in a very specific form of comedy. Mainly that performed by Robin Williams & he alone.
Improv doesn’t belong in any other form of entertainment or activity. This includes political decision making, city planning & resident doctor training pathways.

I thought the BMA GPs were more powerful…

Imposition happens often. The changes in T&C are usually not agreed upon by the union and they remain in dispute. However the changes usually dont meet the bar required for members to vote for strike action. The initial Hunt strike ended in dispute with imposition.

Who else do they work for? Obviously some can go private but some areas are not likely to have that option. The NHS is a monopoly

The constant misinformation from the UK media is depressing. Emma unpicking the lies once again

Thank you to delegates for attending today’s consultants conference, and to our members who watched on the livestream.

Missed it? The recording will be on our committee webpage: bma.org.uk/what-we-do/c...

Vote now to have your say on the 2026/27 GP contract which is being imposed on GP practices in England. GPs are being asked to do more and more, list sizes and GP-to-patient ratios are expanding while continuity of care is shrinking.

Can he impose a GP contract?

Can’t GPs walk/opt out of it?

(Genuine question)

This year @rthonwesstreeting.bsky.social imposed a new GP contract

Provided an extra £1.50 to uncap the number of calls or requests per day & stand by the phone or computer

And if the job isn’t completed within 24hours the GP will be sanctioned

Job specifications below - can’t see a problem🤷🏻‍♂️

It’s really hard- but for trainees with disabilities, knowing what adjustments are possible helps make career decisions- to get half way or further through a training programme having been led to believe they can complete it, to be told x is a problem, is really unfair

Accommodations are so varied and subjective. What might be feasible at a larger tertiary unit may not be possible somewhere smaller. Is there a baseline level of expertise and skill that’s mandatory in order to be defined as x or y? That also extends to things like working hours … Lots of worms…

A picture of an HMRC self assessment

Want to claim tax relief from HMRC on BSE membership subscriptions?

The BSE is recognised by Her Majesty’s Revenue and Customs (HMRC) as a professional body and you can claim tax relief on annual subscriptions through a self-assessment tax return: https://www.gov.uk/self-assessment-tax-returns

Daniel Radcliffe refusing to wear Alyssa Liu's gold medal because it feels like "stolen valour" is the most Daniel Radcliffe thing that Daniel Radcliffe has ever done. What a superstar.

(Found via threads, original source unclear - but thank you!)

All for reasonable adjustments and opening access.

Argument is that medicine is a cognitive process. Procedural skills can be undertaken by a technician.

I don’t need to be able to POCUS/auscultate/venepuncture. If you can give me the accurate salient info I ask for, I can diagnose and manage.

Thanks, I was actually stating the current situation - accreditation is not necessary under the UK ICM curriculum nor mandated by employers. That’s the regulators position too. The GMC has also actively moved away from creditionaling style model. Whether that’s right or wrong is a debate!

Also the central/arterial line point is interesting. Did you know prospective medical students were being turned away from medical school if they couldn’t physically perform CPR. The GMC had to produce a clarification statement on this to stop that happening recently:
www.gmc-uk.org/cdn/document...

I'm still confused by the fact that we think POCUS accreditation is important enough to be on ICM ST3 scoring criteria and POCUS governance is stressed heavily in GPICS V3 but when it comes to the curriculum...

IT’S-A-ME, LINK-IO

WAHOO!

Would be very interested to hear his reasoning on this. I can see the downsides to the accreditation model but I am concerned that an entrustment model leads to a wild west of 'dabblers' in reasonably short order and unless you have a tight rein on governance, all sorts of things can happen

Sneak preview

Sam was instrumental in getting echo credentialling as part of the Australian College of Intensive Care Medicine curriculum (they have to be the equivalent of FUSIC Heart positive to CCT)

And he thinks it’s a failed paradigm…

Huge variation.

Could argue it’s not that different to an entrustment scale.

As you state elsewhere, the most important aspect is governance, image storage and senior support.

Even credentialling has problems

I’ll be talking about this in Manchester in April

Nailed it

Provided we have the capacity to record images for review

And we have enough people to provide that senior review (not a problem at Kings…)

Its focused US. Is there a big effusion, is the heart beating a lot or beating a little. Everything else can wait until the morning in the vast majority of cases.

I’m not so sure about cardiology…

They also work currently on an entrustment-type system

And that has consequences

My worry is the approach of seeing accreditation not being necessary where a DOPs is seen as sufficient.

Cf RCEM.

It is interesting that neonates and resp also mandate POCUS, but without accreditation.

Cardio and AIM however have a very structured approach.

Screen shot from linked paper “The UK intensive care curriculum does not mandate proficiency in any specific procedural skill. For example, there is no requirement to be competent in central or arterial line placement by the end of training. By the same provision any skill can be learnt within the curriculum, such as echocardiography. However, that has not led to the consistent delivery of ultrasound training to those who want it.”

Thanks Segs, just read it.

Trainees could CCT without being able to site a CVC/A-line is quite the comparator!

I see where @waqasakhtar.bsky.social is coming from and why the approach here is to move POCUS beyond specialist skill, or procedural.

🫁 Persistent air leak (PAL) is more than a bubbling chest drain. In critically ill patients it can severely affect oxygenation, ventilation, and lung expansion and may require bronchoscopy, surgery, or even ECMO.
Read more in the #BJAEd: www.bjaed.org/article/S205...
#CritCare #ICU #Anaesthesia