In that response in the BMJ from Dr Hall, he makes the interesting point that Jeremy Hunt first mentioned the 15% increased death rate in patients admitted on a Sunday a month before the research paper was even accepted for publication in the BMJ, and 2 months before it was actually published.

To quote Dr Hall:

…there continue to be a number of unanswered questions regarding how it was possible to indicate that this paper would be coming out in the BMJ – 1 month before it had actually been accepted for publication. Also how data within it were made available for prominent political use – 1 month before it was accepted for publication and 2 months ahead of actual publication. Also given the importance of this issue illustrated by David Cameron’s speech 4 months prior to publication, it seems relevant to ask about any role that politicians had in commissioning and interpreting this analysis in the first place.

(my emphasis in bold)

d Junior Doctors aren’t getting a pay cut or being asked to work 70 hour weeks – they are simply being asked to accept the same working patterns as Nurses and Paramedics. They will still work 40 hours a week but will have to work one weekend in four as part of contracted hours rather than on the voluntary basis that makes no sense at all in health system that’s supposed to work 7 days a week. The principle of a contract that covers 7 day rostering was something that was first accepted by the BMA in 1999 but 16 years later they are still using delay tactics to stop it.

This is so much bollocks that I don’t even know where to start…

1) it is a pay cut – it is
2) junior doctors work almost identical working patterns to nurses and paramedics, except that we tend to work longer hours on average per week
3) I have never seen a contract of 40 hours/week – the vast majority of doctors’ rotas are 48h average weeks (my last official hours monitoring was 49.1hrs/wk, which, incidentally, is illegal)
4) junior doctors already work weekends – a typical rota will have 2 weekends every 10 weeks i.e. 1:5 weeks have a full working week, then 3×12 hours over the weekend, then another full working week before a day off
5) there is nothing voluntary in a junior doctors contract

But surely at your appraisal if you’ve done good work you get an uplift if not you stay where you are. Reality is most doctors are highly driven individuals so I doubt it would be that hard to show progress. Failing that allow market forces to work and move job.

Our yearly appraisals have no bearing on how much we are paid. There are no yearly bonuses. The appraisals are there simply to check that we are hitting training targets (e.g. done a certain number of procedures, seen a certain number of symptoms/diagnoses – one of the things I have to get “signed off” is “genitourinary discharge”…). If we don’t hit the targets, we are “held back” a year for further training.

Non-consultant/GP junior doctors aren’t allowed to work for anyone other than the NHS – i.e. there are no market forces because we are not allowed to work for private companies to the exclusion of the NHS. The GP in the example above will be a fully qualified GP, so therefore not a “junior doctor” as is being discussed at the moment.

I can volunteer to do extra shifts either through my hospital or through a locum agency. The nationally agreed hourly rate for my experience (9 years post graduation, senior registrar, competent to do the procedures listed above) is £32/hr. However, this is over and above the hours that I am contractually obliged to work for the NHS.

There is also a clause in my current contract that says, in “extenuating circumnstances”, I can be forced to work extra hours for no extra pay e.g. if someone calls in sick and there’s no cover.

Oh, and “Foundation Years” in the table is post graduation (they’re usually the first doctors you see when you’re first admitted, the ones that take your blood, request your X-rays, make the first diagnosis, start treatment, refer you to specialists, and do your discharge paperwork).

I didn’t, and I don’t think things have changed in the last decade, although I’m happy to be corrected. It might just be that those students had to move because their flatmates had all finished their degrees and got a job by that point (plus it gets a bit tiring living in a scummy student flat when you’re in your mid twenties)

Most medical students won’t get summer jobs – typical terms are much longer than other courses (for my final 2 years I had 4 weeks off in summer and a week or two in autumn/Christmas/Easter). Lectures are usually M-F 9-5 as well, so the only time they can have a part time job is in the evenings. I didn’t have the time to work after third year and relied on the Bank of Mum and Dad for living expenses (only received a £1k loan per year from SAAS/SLC – I was lucky that my parents could afford to support me).

Med students currently pay full £9k fees for the first 4 years. The final 1-2 years’ fees are paid by the NHS. There are no bursaries or payments available whilst at med school (unlike nursing degrees), apart from the usual hardship funds available to all students.

I qualified as a doctor (after 6 years at uni) in 2006 and, at current full time working, will be eligible to apply for consultant posts as a cardiologist in 2018. That’s 12 years as a “junior” doctor.

However, if you have a heart attack and need someone to unblock your arteries (or your heart stops and you need a temporary pacemaker, etc etc), then I’ve been able to do that for the last 3 years – we’re not totally useless! There are probably less than 300 people in the UK (discounting the cardiology consultants) who have the same skills as me.

At the moment we do pay tax and NI on our full pay (basic + banding), it’s just not pensionable.

A typical 1A rota (50% banding, the most common banding in hospital specialties IME) will work around 1/5 of hours outside of the 7am-7pm Mon-Fri “normal working hours” at the moment. That’s around 10 hours per week that are anti-social currently.

Those pics look amazing! Would you be able to email me the GPX files too? My parents live in the Ardeche (on the edge of the Cevennes) and I have a bike out there, but I’ve had a bit of trouble finding routes around there.

Kielder 101 yesterday in cracking weather (and I won a skills course, which is sorely needed), then an accidental 70km CX ride with friends as a “recovery ride” today (excellent scone and homemade jam at the tearoom in Blanchland halfway round to keep me going).

Very unlikely based on yesterday’s riding! By the time I got to any of the technical descents, I was so tired and sore that I was just pointing the bike and clinging on for dear life!

@thenorthwind – aha! I knew you were an STWer when you made that comment about T5s in the car park! I didn’t want to out myself as a sad internet geek though! Thanks for keeping me company on that long drag from Newcastleton, and sorry I abruptly dumped you at the last feed station – I had terrible cramp in my calf and I thought that if I stopped, I’d never get back on the bike!

I feel like a walking midge bite today though. Those buggers are vicious.

And I put my finishing beer in the freezer to have with my takeaway last night, then promptly fell asleep on the sofa. Freezer now covered in lovely frozen ale… :(

Midges were out in force at the presentation this evening too! It was worth me staying though – I somehow came 3rd lady in a respectable ish time of 7hrs 8mins, and also won a spot prize of a skills course with Cyclewise. My Garmin clocked the ride at 99km and 2300m ascent, so a little short on both counts. Good atmosphere, good cake and excellent weather made it a grand day out though.

I’m in, on a Canyon Nerve full suss 26er. Optimistically aiming for less than 8 hours (if I actually finish!)

You have different max HR for different sports. A lot of it is to do with whether your body weight is supported (eg cycling) or not (eg running).

:(
But I like that tyre (Conti Rubber Queen)

Cheers Josh, will try that

https://www.strava.com/activities/298028883

That’s the route for the black+red mashup that takes in the best of both. 17km – should take around 90 mins for the loop.

Start on the black and do the climb, Pikes Teeth, river crossing, Root 666 and the new Oddsox descent. That spits you out at the foot of one of the red descents. Turn left then immediately right up a fireroad, then right again at the crossroads and climb past the top of Accelerator and the bottom of Transmission. Take the left turn up a rooty ascent, then turn right at the top, which will take you up to the mast. Do the Transmission, Accelerator and Nitrous descents and arrive at the bottom of the Grove again. From there, take the fireroad to the forest road and turn left at the bridge then immediately right for the long climb up to Section 13. At the bottom of Section 13, follow the black trail again back to the main car park (down Boneshaker, Special K and Brain Freeze).

Three meteors in 10 mins just west of Newcastle, then bed for me too :-)

I LOVE this kind of stuff. Who can beat an entire album of German punk/metal bands covering ABBA songs?

We have a road near my house that illustrates the opposite of this point. The council, in their wisdom, have painted a cycle lane on each side of the road. Which is great, except the road now isn’t actually wide enough for even a normal sized car, let alone the Range Rovers and vans that frequently drive up and down it.

Before the lines were painted, vehicles overtook cyclists fairly considerately by going over the dashed centre line into the other carriageway. They now assume that there’s enough space without doing this, leading to breathtakingly close passes as the driver thinks there are effectively two lanes and they don’t have to move over. An example of when a cycle path has actually made things more dangerous for cyclists rather than less.

http://singletrackworld.com/forum/topic/going-to-paris-and-nice-for-12-days-any-tips

Well, the weather is utter pants at the moment and I feel like I’ve been struggling in the short course XC races I’ve done this season (I wasn’t very diligent about the turbo training this winter), so I thought I’d do an 8 minute test this evening to get a feel for where my fitness is in relation to this time last year.

Surprisingly, I’m only 5W (virtual power) down on last year’s all time high FTP of 215W, and up a reasonable amount from my last test in November (202W). I also managed to go over what I thought was my max HR (hit 192bpm when I thought my max was 191), so I definitely gave it my all. I also realised that cooling is a major problem when turbo training in the summer – I’ve only ever used the turbo over winter previously and I was melting despite the autumnal weather outside.

My plan is to try out the MTB marathon training plan with a view to doing the Kielder 101 at the beginning of September. I suspect my recent woes with XC racing are down to carrying a couple of kilos of extra padding, and finally having some proper competition in the women’s races, rather than lack of fitness.

Time to stop eating quite so much cake…

Was just about to suggest the Simonside/Rothbury loop, but I see that’s already been suggested (with a link to my route :-) ). That GPX file will just take you down the main track back to Rothbury past Cragside, but there are plenty of more interesting singletrack diversions if you look on Strava or follow your nose.

Congratulations!

I have no suggestions but am shamelessly bookmarking as my other half proposed 10 days ago and we have a similar wish list

Some amusing responses (and awesome photos) going up on their Facebook page

YGM re parking in Ryton

I did it a couple of weeks ago. A van overtook me and then immediately cut in front of me. I was so busy giving him the finger that I didn’t realise he’d stopped in traffic and went into the back of his van. He gave me the finger back, which was probably fair.

I love the Flyby feature!

A couple of weeks ago, on the 7am commute, a bloke flew past me in full Strava mode, shouting “on your right” as he passed me and clearly taking full advantage of the strong tailwind that morning. Flyby meant that, when I got to work, I could find him and rib him about the fact that he only got 5th on the segment (and that my QOM was still faster!) :D

We found parking in Nice really expensive. Made the mistake of hiring a car when we arrived then paying €€€ to park it underground for 4 days whilst we took public transport everywhere, before driving it north on a road trip. If we did it again, we would hire from in town if we were going to stay there for a few days first. IIRC the car hire places are just off the Promenade des Anglais at the foot of the main street.

dirtyrider – Member
this is great

Yeah, I’m not getting much work done this afternoon :D

It was a puncture for Contador on that descent. Only has one team-mate left…

Edit: 2 team-mates now

Bookmarked for a couple of year’s time :D

The old town in Nice is lovely. Loads of excellent cafes, bars and restaurants. You must go to Fennochio’s ice cream shop too – it takes up an entire side of a square and has every flavor known to man, plus several hundred other ones!

Monaco is an easy day trip on the train from Nice and worth a trip, if only to see how the rich and famous live (and have an expensive coffee in Casino Square whilst watching the supercars go round and round.

My pet surgeon says that a Tier 2 MSK appointment is a good place to start as they’re essentially a diagnostic service with access to bone/nerve/physio specialists as necessary. We both agree that, if you have nerve symptoms, an MRI will help to clarify exactly what’s going on in there.

Thanks, have downloaded some GPX files from wikiloc.

I suspect my parents will be having a whale of a time whilst I’m off getting dusty in the hills :-)

It’s not a race[/url]

It’s a race.

Bump for the evening crowd

A ride in the Dales from Reeth:
https://app.strava.com/activities/171681530