Mark Bagnall PhD FRCS
@MarkBagnallSurg
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Colorectal Surgeon - #hellomynameis - compassion, empathy, integrity - proud NHS - loving husband - LGBTQ - he/him
England, United Kingdom
Joined July 2016
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Pinned Tweet
Thank you for your kind words - they mean a lot. I do remember you and how hard you worked. I whole heartedly agree - those times were tough. I still have some of the psychological scars! Always be true to yourself & be kind to others. So pleased to see your successes!
@MarkBagnallSurg
- I don’t know if you recall - you were an excellent and really supportive surgical SHO whilst I was the surgical FY1 at RSCH back in 2007! Those days were tough!
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As a doctor now I can’t even get a free pen from the pharmaceutical industry in case of conflict of interest. The same standard should be brought into government.
More than 100 MPs received freebies worth £180,000 this summer
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@Thehitmonliam
Impressive achievement.
Wish society could appreciate the same person in both pictures equally.
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Three things surgeons discover (eventually).
I love being a surgeon. I trained hard. I want to do the best job I can.
Family is more important than work.
As soon as you leave/retire you are replaced and quickly aren’t mentioned again.
#lifeistooshort
#WorkLifeBalance
Stop sacrificing yourself for your profession if it means ignoring the feelings of dread, fatigue, low motivation and foggy headedness. These are indicators of a toxic workplace. It might not feel toxic to others but it's certainly toxic to you now.
It's not noble to stay.
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Bumped into one of the F1s I had clinically supervised this year.
“Well done on passing your F1 year, what are you plans.”
“Doing F2 and then going to Australia 🇦🇺.”
“😮”
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After hectic 2weeks, thousands miles 🚙 & too little 😴 I’m delighted to finally celebrate with my husband
@PaulCDent
my new Colorectal Consultant post
@RVI
@NewcastleHosps
. So grateful to be joining an amazing team
@hjg34095197
@petercoyne1982
@bengriffiths73
@researchactive
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@ajbaker2011
@OrthopodReg
@beckybeckyfish
@RoshanaMN
@parthaskar
@OrthoDiversity
@WomenSurgeonsUK
@RCSnews
@orthoWOW
@speakuportho
@BAPRASvoice
@PLASTAUK
Can all NHS leaders & managers agree that if sexual assault happens we phone the police. It isn’t a HR matter it’s a criminal one.
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A clinical fellow sanctioned because they did not adequately supervise a PA.
Deeply troubling.
First, isn’t the consultant ultimately responsible? Second, what was the Trusts policy on PA supervision.
Easy to scapegoat an individual. But that doesn’t fix the system.
A fitness to practise tribunal (MPTS) determines that a PA's history should be repeated by a doctor and a PA's examination should be repeated by a doctor too.
DAUK's report in Pulse explains more 👇
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@bfhermann
@residencyreview
The culture was the same once in the UK. It doesn’t have to be this way. As a surgeon and medical educator I see no advantage in teaching by humiliation. Change the culture. Break the cycle.
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I don’t normally share thank you notes. But given all the (legitimate) negativity on Med Twitter in surgery I wanted to express how grateful and privileged I am to work with so many amazing, fantastic, talented doctors. These cards will always mean so much to me. Thank you ❤️ ❤️
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I once discharged a young girl with 10d of diarrhoea. Her family had recent D&V bug. She wasn’t vomiting. Her presentation had no typical features of appendicitis, nor her examination, nor investigations. She represented 48h later & had laparotomy for perforated appendicitis.
Once again, reading accounts of GMC investigations makes my blood run cold.
An experienced doc makes an error in a busy ED.
Co-operates fully.
GMC tribunal punishes her on the grounds that it 'highlights' the matter to the profession.
Ie. As a warning
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Occasionally I feel guilty doing a high-risk operation instead of trainees. But 5 recent SpR trainees said they all have progressed considerably in their surgical learning curves & get to do far more hands on than they expected. I’d never send my trainee for ☕️, I’d get them ☕️.
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Sounds like if core trainees in surgery could have this type of job plan and renumeration then we wouldn’t have a retention / recruitment problem.
@ollieburtonmed
@MarkBagnallSurg
I am finding these posts about PAs and their job plans very concerning. An SHO would kill for a job plan as above. The entire reason for taking on para-medical staff was to enable our SHOs & FY1/2 to get to their training. Here it looks like the PA is hoovering it all up.
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All surgeons will recognise this 👇
👏
@lubitz_carrie
saving more lives with her bravery and honesty 🙌
@guardian
@AcademicSurgery
@AmCollSurgeons
@AmerMedicalAssn
Surgeons are killing themselves at an alarming rate. One decided to speak out
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@EKing719
Reading the responses my first thought is why is asking for a second opinion or specialist opinion disrespectful?
Inequalities & inequities sadly do exist in all health systems, hospitals, even on different shifts.
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Oh my. I’ve been treated to champagne, home made delicious beef wellington and now passionfruit soufflé with white chocolate ice cream (which my gorgeous hubby did all from scratch!!). What a Christmas
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Surgeons are not ‘gods’. Never have been. Never will be.
Some may have God-complexes.
May I suggest if you ever end up under the care of a Consultant who thinks they are a ‘god’, ask to be transferred to someone else. Quick.
@RCSnews
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Go ask the anaesthetist if we can book another case onto the emergency list…
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@lauraelizakay
😂 yes it’s annoying.
“Are you sure you don’t want a twin room.”
“Well, let me just check with MY HUSBAND. Nope the double is fine.”
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Postop complications - no one really prepares the surgeon for how to personally face the guilt/emotional impact of own actions.
Every surgeon has complications, sad truth. Because every surgeon is human.
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@drkeithsiau
Make sure it isn’t a keratin plug!
Sister Mary Joseph node is rare as unicorn.
More likely a paraumbilical hernia with evidence of fat/bowel strangulation.
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@timcs1968
@r1chardf1tzg3r1
@RCSnews
@TMitchellFRCS
@AoMRC
@RCSEd
@rcpsglasgow
@TheBMA
@ASiTofficial
@bota_uk
@asgbi
@BritOrthopaedic
@the_mdu
@MPS_Medical
@AvMAuk
@PatientsAssoc
@WhichUK
@bmj_latest
@bbchealth
I am sure that all surgically minded foundation doctors would love 2 weeks of dedicated training paid for by HEE.
Some surgical core trainees get a ‘bootcamp’ in different regions for 3-5 days if they are lucky. It’s not universal.
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@RoySocMed
At first I thought maybe.
Now I’m convinced that GEM route into medicine is the best option rather than PA.
Doctors assistant (band 3 HCA) seems to fulfil the original intended admin support role.
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A trainee asked me why aren’t the surgical courses automatically embedded into the training system.
@RCSEdFST
@RCSnews
@RCSEd
@ACPGBI
@asgbi
@ASiTofficial
The average UK surgical trainee will spend £9105 on courses
#costoftraining
#choosewisely
#surgery
#surgtiwtter
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It does very much seem like some PAs are deliberately obfuscating titles.
I remember at medical school being told never to call myself a ‘student doctor’ only a ‘medical student’ so as not to confuse patients.
This just undermines confidence in the entire profession.
I also do feel somewhat sorry for PAs in this, I guarantee the vast majority aren’t fuelling this political drive to blur the boundaries in roles. But the only way to help is to be open/honest and open to concerns/criticism
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@doctor_jef
Interesting to see the other side, as someone who receives these letters.
Currently 14m wait to see me if routine referral. I really hate this. I’d love to get the wait times down.
I’ve already done extra NHS theatre/endoscopy/clinic sessions. But demand/referrals increasing.
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@ujwaliofficial
A US Trauma surgeon said to me prehospital the best resuscitation fluid for a bleeding patient is gasoline - get them into hospital quick.
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We must acknowledge Trainees work incredibly hard & under pressure to attain targets to progress: WBAs, logbook cases, exams, audits, presentations, publications, teaching, courses, leadership positions. They do this while on anti-social rotas & imploding social lives.
#respect
We understand the anxiety caused by the delay in releasing
#MRCSA
results. We will continue working with the ICBSE and provide trainee representation to raise the growing number of concerns. Please continue to communicate them through your ASiT regional representatives.
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@Neil_J_Smart
@ASiTofficial
@Dukes_Club
Lots of evidence that trainees supported by consultants in the operating theatre have same or better outcomes than consultants alone.
If we don’t teach & learn in the operating theatre (with patient safety paramount) then we’d have no competent surgeons within a generation
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Seems like a legitimate & robust response from
@ASiTofficial
to the recent article published in
@RCSnews
@RCSEdFST
#notrainingtodaynosurgeonstomorrow
ASiT and the Surgical Specialty Training Organisations have released a joint statement in response to a recently published in The Annals of the Royal College of Surgeons England
What should be the
#priorities
in delivering surgical care?
Share with us your thoughts
🔗
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Anyone else a little saddened by the medical student perception of surgeons
@jamestoml1
@OrthopodReg
@LiangRhea
@Humphrey_scott
@svig2
@SWexner
@ASiTofficial
@asgbi
@ACPGBI
@EYCN_ACP
@RCSEdFST
@RCSnews
@RCSEd
Dear Doctors
While
#MedTwitter
has the conversation again about specialty stereotypes, it is worth remembering this research poster
Opinions (and future choices) are influenced by what students hear and see
#RoleModel
#career
@JonnyGucks
@LiangRhea
@OrthopodReg
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“Lonely”. For example if you a feeling lost in an operation, tissue planes or structures not making sense. Ask a trusted colleague to join you in theatre.
I have great colleagues who I can and have counted on to do this.
#patientsafety
#humanfactors
@RCSEd
@T4UGIS
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@found_a_lock_in
@JackanarchyCR7
@Thehitmonliam
Person isn’t any more or less worthy depending on their weight.
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The Open Abdomen webinar
@slade_dom
@RCSEd
- “10 Commandments”.
Mesh mediated fascial traction is excellent option for staged abdominal closure to avoid ventral hernia.
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Beware workaholism! Make the time to live not just work.
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Excited to hear from
#orthopride
@jaimelbellamyDO
@RCSnews
#OutattheCollege
I never considered orthopaedics as a credible profession for me as a gay surgeon due to alpha male barriers & toxic stereotypes. So glad that people out there to
#hammeritout
@NickFerran
@OrthopodReg
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@justinmaykel
@SWexner
@ehaasmd
@MarkSoliman
@AntoninoSpin
@SAGES_Updates
@SamAtallahMD
@vincentobiasMD
@DCRjournal
@RoelHompes
@KnolJoep
How about something more controversial. How can you/we justify using highly expensive medical technologies when there isn’t equity of access to affordable basic healthcare?
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@jtrebach
I once had a (delirious) patient point at me and shout: “That’s him, he’s the murderer.” Then go back to behaving perfectly normal.
The more I protested to the wide-eyed watching other patients the guiltier I came across.
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What an absolutely fantastic conference
#ASGBI2024
Belfast.
Glorious weather. Great company. Fantastic presentations. Amazing attendance & engagement. Trainee villages. 🇺🇸 speakers. I have had a great time.
Happy to represent
@RCSNews
@PRiSM_Surgery
@ASGBI
.
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@OrthopodReg
@BowaterComms
@rebgross
@UKWENTs
@WomenSurgeonsUK
@RCSnews
@RoshanaMN
@trishgreenhalgh
@doctor_oxford
@sbattrawden
@parthaskar
Historically, intelligent abusers cloak themselves with respectability & acts of charity & virtue to make others disbelieve they are capable of such actions, while seeking opportunities to commit their abuse.
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What are the characteristic of a great surgeon?
Compassion integrity empathy
Skills man, skills. Judgement and skills; the two questions I ask of faculty referring applicants.
Characteristics Associated With Outstanding General Surgery Residency Graduate Performance, as Rated by Surgical Educators | Medical Education and Training
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@WelshGasDoc
Imagine all the private business he is now going to get from all the anti-vaxxers thanks to Sky News. Is that his agenda?
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Wonder if this translates to surgeons…?
Bosses who insult and intimidate don't get results. They leave people scarred.
Data: when NBA players have abusive coaches, they play more poorly for the rest of their careers—and commit more technical fouls.
Weak leaders make people weaker. Strong leaders make people stronger.
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What an absolutely fab cross-regional Training Day
@royalhospital
!
It’s had such a great buzz!
50 surgical registrars in attendance
Great speakers - so much engagement / interactivity with audience 🥰
Incredible
@Ethicon
support with the wet-lab anastomosis parallel sessions
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Dear
@RCSNews
Thank you for sharing the letter of the opinions of a retired surgeon.
I vehemently disagree with everything his has penned and am frankly insulted by what he has written.
I hope when I retire I have the grace and humility not to do likewise.
Dear
@RCSnews
This is not ok
These attitudes are never ok
Mr Piper is retired but I wonder if he and the Editor could have a cup of coffee soon.
#HammerItOut
#orthotwitter
#SelfCareIsHealthCare
#BackInMyDay
#mentalhealth
#Wellbeing
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Certainly becoming surgeons has prevented
@PaulCDent
& I becoming
#ParentsinSurgery
.
Married gay surgeons do not meet the criteria for adoption. The uncertainties, poor economics, difficulty putting down roots, long commutes.
We welcome change
@RCSnews
@PRiSM_Surgery
Today we launch our new
#ParentsinSurgery
report. Hear from our Vice President Fiona Myint about why this project is vital to cultivating a diverse and effective surgical workforce. Read the full report and join the conversation:
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I had a patient in clinic today tell me they had found me on Twitter.
Just for a moment that flummoxed me 😯 but on reflection I believe it’s a positive thing.
I’ve always used social media as a professional-peer communication & learning tool. I realise it’s more than that
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@elinlowri
As an SHO I rang my sleeping non-resident surgical SpR for advice on a delirious pt trying to abscond the hospital. Their partner (Consultant Psychiatrist) answered & gave me a fantastic management plan. Best call I ever made.
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I get funny looks when I point out to the people in theatre that distracting the trainee surgeon at the most critical point to ask them in advance what the resection specimen (which hasn’t been removed yet) is going to be called is not a good idea.
About to publish study with about distractions in the cardiac catheter lab
Distractions occurred in 55% of invasive procedures with some at high risk stages
80% were not even related to the cardiac procedure!
We must minimise distractions at critical times to improve safety
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The magic white line of Toldt
Austrian surgeon and anatomist Carl Toldt (1840-1920) described a ‘white line’ which separates the mesocolon from the retroperitoneum. The “white line of Toldt” has become an important landmark in colon resections, as opening it allows for the colon to be mobilized.
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@mstotty88
I believe in rewarding based on merit. Also know selection systems are flawed & (historically) racist/prejudiced. Also aware that more than one path to same destination. Sometimes the atypical route brings more rich diverse experience.
This topic is far too nuanced for ‘X’.
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#Outatthecollege
#LGBTQ
+ conference at
@RCSnews
Fantastic, empowering, encouraging, progressive, undeniable. Culture change in surgery driven by passionate people
@GinnyAB
@mortensen_neil
Karen Chui, Xander, Alex Ashman
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Before speculation on stoma-free outcomes shouldn’t we ask the patients their wishes - do they want to keep their stomas? What is their GI function with or without a stoma? What is the quality of life? We need to connect qualitative and quantitative data.
Defunctioning stomas may reduce chances of a stoma‐free outcome after anterior resection for rectal cancer
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How to sound clever during surgical ward round.
🗺 Know where the pt has been moved to?
🤕 Start w anyone unwell or needs op
🗣 Succinct case presentation
🚴🏻 Physiological fitness, 🏠, frailty
🫀🫁 Consider non-surgical differentials: ECG, CXR, bHCG
🕵️ State next test/Rx plan
How to sound clever during a ward round 🤓
🗣 One liner case presentation
🗂 Use a classification system
📖 Cite a study acronym
🧬 Go to the cellular level
💊 Talk pharmacology
👨🏻🎨 Touch on medical history
💬 Quote an expert in your field
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@doctor_jef
Labour government in 1997 brought the waiting lists down from 18m to 18wks. Just saying it is possible. But takes government will.
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Are high stakes postgraduate exams fit for purpose?…
Please tell me the side effects for drugs that you never prescribe.
@OrthopodReg
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5 years ago today a Grand day out
@RoyalAlbertHall
for PhD graduation. Thanks mum for all your support over the years.
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Always a place for maximally invasive surgery. Knowing how to quickly gain entry into a body cavity to stop bleeding and control contamination is an absolutely vital skill. Even if you don’t work in trauma centre, may need to manage an iatrogenic injury.
In an age of advanced robotic surgery, is there still a place for maximally invasive surgery? In this
#Bulletin
, we explore the development of robotics and keyhole surgery and ask whether there is still room for the more traditional approach.
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Interesting and timely paper. Supports the philosophy I was taught, in an emergency do what’s necessary and no more. Come back to fight another day.
@Neil_J_Smart
@hjg34095197
@RiaRosser
@BhallaAsh
Increased risk of postoperative complications with retromuscular mesh placement in emergency incisional hernia repair.
#OpenAccess
👇
@PaulinaSalminen
@villesallinen
@henrikthorlaci1
@KariTikkinen
@MalinASund
@YaqubSheraz
@PeterStalberg
@HerniaResearch
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@justinmaykel
@SWexner
@ehaasmd
@MarkSoliman
@AntoninoSpin
@SAGES_Updates
@SamAtallahMD
@vincentobiasMD
@DCRjournal
@RoelHompes
@KnolJoep
Or how about this one… Which would you/we prefer to finance:-
A new surgical robot or
Surgical nurse:patient ratio of 1:1
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All surgeons have complications. How we manage them goes beyond the technical: acceptance, empathy, communication, self-support, navigating the medicolegal processes, wider support.
#ASGBI2024
Fascinating Medico-Legal Symposium with lots of discussion and wise words from our judge
#ASGBI2024
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Great privilege to co-chair acute appendicitis: the big unknown
#ASGBI2014
Prof Nigel Hall - inviting participation in studies of appendicitis management in children
Miss Eleanor Massey - presenting thematic analysis of pt & surgeon interviews of Abx /surgery for appendicitis
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Unfortunately this is what happened and is still happening to me. I love being a surgeon but I have to keep asking myself is it really worth the sacrifices and compromises…
I'm a doctor.
My partner is a doctor. We are both at the same point in our training.
We have no guarantee that we can live in the same area when we enter further training.
We could end up opposite ends of the country. I've trained for years and the system couldn't care less.
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@SurgJournal
@SWexner
@juliomayol
@JBMatthews
@SyedAAhmad5
@luciacolorectal
@UCincySurg
@nlavellaneda
@docmartin22
@rbarbosa91
Resilience is about institutions not individuals.
Bricks aren’t resilient, well designed structures are.
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I managed to watch this. It was tougher than I was expecting. It’s an absolutely true reflection of what was happening in the NHS.
My father died of complications following a stroke during COVID and I spoke to him via an Ipad. I couldn’t be with my family. Horrible times.
#Breathtaking
on
@ITV
Extraordinary
@doctor_oxford
I give my eternal thanks to all in the NHS for their courage
And my utter contempt for those in governmemt
Partying, loathsome, lying, grubby politicians who handed billions of pounds to donors & cronies for faulty PPE
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@Microbedoc2
I was part time locuming in ED (I was broke post-PhD, main job surgical SpR).
IVDU groin bleed ‘said spurted up wall’ now stopped. Pressure dressing. XM. Awaiting transfer vascular unit in next hospital.
F2 covering gen surg comes down, takes off dressing, probes wound in ED
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Professor Sue Clark is an amazing professional. When she says the words “It feels terrible” I feel exactly what she means & totally empathise & completely agree with her.
We want to do the very best for our patients & not being able to do so is one of the hardest things to face
“I’m seeing wave after wave of people coming through the doors of the emergency department.”
Surgeon Sue Clark tells
#Newsnight
she and her colleagues at Northwick Park Hospital are “overwhelmed” with patients, adding it will “take years to get back onto any kind of even keel”
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Fantastic day teaching Definitive
#Surgical
#Trauma
Skills
@RCSnews
@RCSEd
in Brighton
@bsmsmeded
with
@traumakhan
@cjaylwin
@McmonagleMorgan
@markedwards999
#SurgEd
#MedEd
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@ujwaliofficial
@toxicologist12
No
@ujwaliofficial
- not things in bottoms... LOST things in bottoms.
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@drkeithsiau
@eljulii37
I know rectal foreign bodies seem like a great topic for entertainment.
But remember sometimes it’s psychiatric patients, non-consensual insertion (rape) & also (not advocating light bulbs though) I want my patients with FBs to trust me that I’m not going to gossip about them.
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True. Based on my family background there is no way I could afford to study now. As it was, graduating med school in 2004, I was broke until about 2y into being a consultant due to all the moving, commuting, exam and course fees.
1. Medicine is rapidly becoming an expensive hobby- working class people can no longer afford to become doctors given the poor salaries and huge debts on graduation.
I am the son of immigrants - I couldn't speak English until i was 5-i was born/ brought up in longsight,
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@drkeithsiau
Part of me does wonder if I would tolerate a gastroscopy better if I did it to myself?…
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My experience in surgery: trainee asks Consultant to do WBA, then trap them in their office, feed them Costa, open up ISCP on their computer, contact helpdesk when Consultant has forgotten their password, complete 99% of the form & Cons clicks validate. Consultant flees.
TRAINEE TIPS: How to complete a Case Based Discussion in Anaesthetics
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Hi everyone, my name is Mark (he/him) very happy & privileged to be husband to a fabulous fellow
#LGBTQ
+ Consultant General Surgeon
@PaulCDent
🦄🏳️🌈🎭 together 23 years! Outspoken & indomitable.
#PrideInSurgery
#colorectalsurgeon
#Outatthecollege
#ILookLikeASurgeon
#gaysurgeon
Welcome everyone! 🖤🤎❤️🧡💛💚💙💜
Whether you're an
#LGBTQ
+ surgeon or an ally, we'd love for you to share a little about yourselves and tell us what
#PrideInSurgery
means to you.
Tweet us using
@PRiSM_Surgery
, and feel free to tag anyone who might be interested!
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@MStott88
Martyn how do we hope to have an inclusive diverse surgical workforce if only independently wealthy upper/middle class people (financially privileged) are favoured to do so.
The societal widen gap problem desperately needs addressing but the two aren’t incompatible.
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@DrBenLovell
Patient complaining of shortness of breath. Hb 71 on 29th Sept (?). Mean corpuscular volume normal. No sign of GI bled given 1 unit packed and 1g of IV iron and repeat Hb now 87.
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This seems to be one of the clearest takes on the PA situation.
It’s becoming obvious that everyone has been sold a pup with physician’s associate roles. Docs thought they were getting a helper, someone to remove some of the burden of admin and chasing for junior docs and who could also do some routine tasks (but under supervision and 1/n
55
820
3K
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***
#ASGBI
Emergency
#Laparotomy
Meeting 19th Nov 2019 ***
Excellent program for all
#EGS
Emergency General Surgeons led by Gill Tierney, Pete Sagar and well represented by
#colorectalsurgery
#ACPGBI
Nicola Fernhead, Andy Miller.
Please attend & retweet.
@asgbi
@ACPGBI
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Lovely email dropped into my inbox today.
DSTS is great course, with great faculty & resources. Thank you all
@traumakhan
@McmonagleMorgan
@An040my
@susanyoong
@cjaylwin
et al.
Loved teaching on the course & pleased to return in Feb back to
@BSMSMedSchool
as full instructor.
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Great presentation from Andre D’Hoore
#StMarksFrontiers2020
going through various options for stricturoplasties
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@angryfromeston
What costs of training?
The F1 has accrued student loan debts and will have worked 2 years in the NHS.
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