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Guest khuram

Open mind--- BUT HOW!

21 posts in this topic

Hi guys

I wonder if some advices could be thrown to me in regards to me having a shitty time with a newly appointed consultant.I am his Sho and finding him very difficult to work with.

Well for starters he is a bloody obssessive person eg.he would not see a patient for more than the allocated time,either 15 or 30 minutes.Does not matter if issues still awaiting to be discussed or dealt with ,clinicaly or other wise.

I have been asked to not to write 'stories'in my out patients letters and just to mention the diagnoses,risk(acceptible or not),medical diagnoses and medication.He is so obsessed with ICD that every patient has to have a diagnoses irregardless of the fact wether they qualify for it or not.

He has asked me to not to disagree with him in CMHT meetings or ward rounds and to discuss with him afterwards.(a patient admitted showing no evidence of a delusional or psychotic feel to his belief of being a subject of talk in his village,showing more of a paranoid feel).Me and nursing staff tried to put the message across but he started risperidone and tried to built it up to 6mg.Well I questioned and the reply was that he believed this man to be psychotic ,demanding neuroleptics because of 'my gut feeling'.Gut feeling MY..............ASSSSSSSSSS.

On top of it he is not a MRCpsych doctor,aaaaaaaaaaaaaa*****.He hold a post graduate degree in psych from an another noneuropean country and has worked for only a year as a sho in this country and then offered a job as a consultant.And would you believe that he took Guildford part1 course with me in late 2003.I am not sure wether he later took the exam and failed it or not.

He now wants to see and counter sign all my out patient letters and discharge summaries before they go out.

May be I am not thinking in the way I should but honestly finding it very difficult to keep an open mind.

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Gosh...

What's your clinical tutor like? Would it be worth speaking to him/her about this??

Of course, all consultants work differently, there will always be difficult ones. It worries me that he doesn't hold MRCPsych and yet is supervising you in a training post (presumably). I wonder where the college stands on that.

Being pessimistic, the reality is probably that you will have to grin and bear it for 6/12, but you will know that whatever he says, you are right!

Asking you not to disagree with him is ridiculous. He should be actively seeking your opinion in ward round, and using the opportunity to teach you if he feels your opinion is wrong. You are the doctor on the ward, you see the patients more than he does.

I hope things improve for you!

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It would be interesting to know about your supervision time with him. What do you discuss? :-/ :-/ :-/

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hi khuram

just to make u feel a bit better, urs is not the only

consultant who wants to check the SHO's letter before they are sent out. I had a similar consultant who was very insecure and would not do even a single ward round without me.

I think it helps to talk to the clinical tutor if u think that one is any sensible and reasonable. This might mean subsequent sho's have a better chance.

good luck

we learn a lot from these experiences, at least will know what sort of consultant we dont want to be to our own junior doctors.

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Is he a locum or substantive ? Has he got CCST, I doubt it ( not European)

There are few Consultants now without MRCPsych ,majority have long experience in psychiatry . I think they can give only clinical supervision but eductional supervision should be taken from Consultants with MRCPsych with CCST or at least recognised by the College as a trainer. I think you need to discuss with your clinical tutor

Good luck

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Sounds like a nightmare situation Khuram.....this 'disagreeing' business seems utter nonsense. How r u coping with all this?

i too agree that u shud seek out the clinical tutor and discuss this beforehand....cos ur RITA would be on its way soon. and u can also let know ur opinion when they ask u for ur post evaluation.

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May I also second all the above. Quite apart from anything else, if this guy is not properly approved as a trainer by the College, he can not act as your sponsor for the exam.

I too have worked with some truly obseesive and bullying consultants- one who berated me in a ward round for changing paracetemol doses without consulting her!!!!

Subsequently, I have worked with some great consultants which has given me the strength to realise it was them not me. I am ok and deserved better than that. I would go to my clinical tutor and then the college if a similar situation were to arise again.

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Thanks guys

I agree that the best way to deal with a situation like this is to take it as a learning experience.

Attending a course now a days about communication skills (Neuro linguistic programming) and fortunately the focus of the course is work related conflicts.Finding it very interesting.

I am keeping the option of speaking to the clinical tutor open.Will try my best to avoid it though.

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Sounds a LOT like my previous consultant. We had him down as having Asperger's  :lol:

I bit my tongue and went along. Didn't want to kick up a stink.

...BUT i know how you feel  :'(

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Your situation sounds ghastly Khuram and I reckon your consultant has insecurity issues. However I must say there's nothing wrong with a consultant seeing a discharge summary before it goes out, personally I think it's very good practice for the discharge summaries to be copied to the consultants as there are, ahem, 'different' kinds of SHOs 8) Just hope you'll never have an SHO who's version of a patient's admission you'll discover is totally news to you when you're perusing the discharge summary in outpatients... :o

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Hi Guys

I must say that my relationship with my consultant is improving.This is not because he has changed his ways(which I still disagree) of working but as a result of me taking a broader view(after attending the course) and he requesting my clinical tutor to swap me with a fresh sho/jho to him(whom he can train as according to his training) because he consider me a senior sho with a different style of dealing with mental problems than him,which apparently make our patients unsafe.

The course which I attended covered many themes.The one which I found quite helpful in this situation was to think in terms of First position(myself),Second position(my consultant) and Third position(A helicopter view-----i.e Just sit back and analyse the dynamic of the situation without sinking into 1st or 2nd position---compeletely detatching yourself).Well it seems that his level of anxieties are quiet high because being new to the system and sueing culture in Uk.He revealed this to me after I refuse my clinical tutor`s proposal to complete my remaining job with himself with a view of attaching a junior house officer to my consultant and then I decided to speak to him directly.

I spoke to him freely but tactfully about my concerns of not feeling as if trusted which I feel I deserve and it seems that he acknowledged that.

And there have been couple of occasions since then when he took my advice on board and I have also found myself using the ICD10 more than usual in my outpatients with a sense of a job well done.

May be I am being a bit naive here but definetely has started feeling more relaxed.

Yes digitalspy I now have no problems with my discharge summaries checked before going out.

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dear Khuram,

Was going thru the replies and your initial thoughts.Arent you glad a forum like this providing a vent to your feelings!!I guess we all have done posts which involved a 'management'task of dealing with difficult personalities!

By the way to throw some light on what seems to be a 'fellowship'doctor,one has to remember these consultants have a limited practical,tactical NHS knowledge and rely a lot on the 'textbook and gut'stuff.They are usually excllent academicians but with poor local understanding.And as someone mentioned the constant worry about performance plays a role.

good thing of sho post,6months flies by and you move on.

all the best

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Dear Ram73

You are absolutely right.Sharing my thoughts and feelings with some of the great minds in the forum has certainly been very useful.One understands how people view things differently.Things and difficult situations which can be dealt with by viewing it with different angles and the fact that how difficult it is to'keep it simple'.

I hope people discuss their work related problems and we could learn the ways to survive and modify our thinking in our journey towards consultancy.

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hiya,

Its nice to know that u have found all our advices very useful, but u were referring to some' great minds'!!!!

Who are they,lol :lol::P

Tell u wot no one is great or is a genius here on the forum, everyone is simple n straight forward!

OR am I blind to some einsteins and faradays on here ;)

Anyway u have improved ur relationships with ur consultant and iam happy for you...cheers:)

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Dear Garamsadhu

Like yourself I also believe that IT REQUIRES A VERY UNUSUAL MIND TO MAKE AN ANALYSIS OF THE OBVIOUS!

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nope, i disagree, it just requires common sense to analyse the obvious :lol:

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Millions say the apple fell but Newton was the one to ask why!

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I was wondering wot the problem was with you n ur consultant?

Now its clear .......the poor consultant was not completely at fault. Some one was on his face all time.... :lol:;):P

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u seem to have dissappeared khuram :lol::P

Just kiddin mate...but u shld really have an open mind as someone has already pointed out to you.

best of luck!

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Dear Garamsadhu

I am still here pal.Your sense of humour is certainly appreciable and thats why no offence taken at all.

But it seems that we have to agree on the above disagreement.

Your point in keeping the mind open,well thats the purpose of seeking all these advices to learn exactly that and not to live only on the intellectual fat with the mind closed up.

Its equally important to recognise that if you keep your mind sufficiently open,people will throw a lot of rubbish into it.

Its a fine balance,is it not?

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hey mate, tell you wot!

I think like myself you are from a different country training for psychiatry here, one good advice to you is not to take in too much and start fightin for equal rights n stuff. If you continue to do so I can see u being thrown out as a rubbish out of the country.I know u have hot blood runnin through ur veins and u are all excited and ecstatic, but please dont spoil ur career by creating ego boundaries betwen urself and ur consultants!

Just a bad reference from one of them might take u from ur dream world high up in the heavens to the rubbish dump of the real world!

As u r profile says- 'everyone is born mad, some remain so'....hope ur are not refering to yourself there

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