Simon Fleming 🛠
@OrthopodReg
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#handsurgery | #MedEd PhD | @Orthodiversity | @NHSProjectS | Culture | @BJSOpen Ed Board | @ClinEdResearch | He/Him
Joined November 2013
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This is the best one yet. Hands down. Because it’s funny. And also true. So true it actually makes me really very angry. Still funny though. #wellness #wellbeing #Resilience #medtwitter #burnout #mentalhealth #MentalHealthMatters @DGlaucomflecken
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Do you value you hands?. Enjoy washing, dressing & feeding yourself?. Recently I did a complex case. I did it as *the* surgeon. I’ve been a doctor since 2006 & a surgeon since 2010!. I am a #juniordoctor. I earned £25.47/hr to rebuild a wrist. #juniordoctors #JuniorDoctorsStrikes
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Tell me again how we should stop talking about these things that “just don’t happen”. #medtwitter #NHS
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Thanks feelings bro . #orthotwitter #DangerSquiggles #ICanManageDiabetes #medtwitter @DGlaucomflecken
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Hey. Remember that time I reconstructed someone’s hand and wrist for £25 an hour before tax. Yeah. Me too. Good times. #handsurgery #MedTwitter #JuniorDoctors #JuniorDoctorsStrikes #DoctorsStrike
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Well. This seems perfectly fine. Thank goodness this exam isn’t a super high stakes exam, normally requiring a year of revision and sacrifice, that decides people’s futures. Oh. Wait. #MedTwitter #MedEd #coda22
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Dear @NHSBartsHealth . Really?? REALLY?!. Some reflection is perhaps is order. #medtwitter
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Hey @thetimes . You appear to have published a hateful piece of sexist, misogynist tosh. It also appears to be apologist for bullying, sexual harassment, sexual assault . What you permit, you promote;. You promote gender based violence. Do better. H/T @rosieICM . #MedTwitter
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Flawless, festive and scientifically accurate. Get your #vaccine. #COVID #CovidVaccine #COVID19 #NHS .
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A brave, powerful & humbling response to the article written by @beckybeckyfish & myself around #sexualassault, #sexualharassment & #rape in #surgery. Read this & perhaps reflect how you, your colleagues or your specialty is working to change our culture.
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If you think #COVID19 cases in hospitals aren’t a *thing*, come & shadow me. Sit with a family while i have the “#COVID + hip fracture” chat. 50% chance of *dying* in 120 days.38% chance of *dying* in one month. COVID makes everything worse.Get your #vaccine. #orthotwitter #NHS
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Let’s not forget. Doctor starting salaries. 🇦🇺: £44,000.🇨🇦: £46,000.🇫🇷: £43,700.🇺🇸: £41,900. Meanwhile in 🇬🇧: £29,384 . The #JuniorDoctorsStrike is both right and righteous. #MedTwitter #NHS #Doctors #juniordoctors
If you’ve not worked in the #NHS. If you’ve never been a doctor in the NHS. Then maybe, just maybe, you don’t get to tell us what it’s like, what we deserve or how we feel. COI:.Started FY1 Aug 2006.Finished ‘training’ Aug 2023.Now; fellowship 🇦🇺. #JuniorDoctorsStrike #MedTwitter.
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Today’s “NHS must change” chat. I get paid fortnightly. just received my first Sydney pay. It’s more (if you extrapolate to a month) than a 🇬🇧 7 year, 12 PA consultant would earn. The greatest resource in healthcare is the staff. Pay them or lose them. #medtwitter #orthotwitter
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Up until last week, I was often the most senior/experienced #orthotwitter surgeon in Europe’s largest trauma centre. Last weekend, I did 8 operations that *saved limbs*. On average, each operation paid me £24-35 before tax. Just saying. #MedTwitter #JuniorDoctorsStrike #NHS
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never worked anywhere with a just #culture like this. Flat hierarchy, empowering all, #wellbeing focus, appreciates #MedEd, not tolerating #bullying, #undermining or #harassment . When this all ends, and it will, i hope people take that with them. #HammerItOut #Nightingale #NHS
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graduated #medschool in 2006. started #orthotwitter training in 2013. As of today, 17 years later, I have finished training. *ARCP Outcome 6*.*CCT +ive*. I’ve received explicit threats to my career *in the last week*, which was super fun, and to them, I say…. #MedTwitter #MedEd
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Amongst the replies to my tweet, I have received another harrowing story of #sexualassault in #surgery. I have been asked to share it by the author & do so with their consent. My DMs are filled with many of these experiences. We can & must do better. #surgery #metoo #medtwitter
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Today’s fracture clinic letters have all the important clinical details. #orthotwitter #NHS #handsurgery 🦖 #medtwitter
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I feel attacked. But I do really like a scrub cap, not gonna lie. *cries in #orthotwitter*. #AAOS2021 @DGlaucomflecken
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🚨🚨 the vote is in🚨🚨. #juniordoctors have voted unanimously to strike. 98.06% yes vote. For the second time in my training, we will do what is right, not what is easy and pursue industrial action. #medtwitter #NHS #NHSStrike
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got the call. I’m off to #NHS #Nightingale . I’ll be #MedEd training faculty, for the amazing humans working there. See everyone there. #medtwitter #orthotwitter #doffing #donning #teamwork #wellness #nontechnicalskills #commskills #NHSNightingale #NHSThankYou #COVIDー19 #COVID19
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The exam took 18 months of my life. It robbed my family of a father & a husband . It cost me more than I can spare, financially, physically & mentally. The current system takes & takes. Infantilisation, lack of respect & harm: Time to change. #JuniorDoctors #medtwitter #MedEd.
When the junior doctors in your family. Are up BEFORE the children on a Saturday morning.👨👦. And revising for exams in their 30s. Pay restoration seems like it should be the starting point for negotiations. And not a level to come down from. #PayRestoration
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If you’ve not worked in the #NHS. If you’ve never been a doctor in the NHS. Then maybe, just maybe, you don’t get to tell us what it’s like, what we deserve or how we feel. COI:.Started FY1 Aug 2006.Finished ‘training’ Aug 2023.Now; fellowship 🇦🇺. #JuniorDoctorsStrike #MedTwitter.
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Dear racists the world over,. Please note:. This glorious human ran towards danger and died protecting people, on his first day at work. While you sow hatred and violence from behind your grubby little screens. Get in the sea, the lot of you. #BondiJunction #BondiWestfield.
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New home is absolutely awful. Awful, I tell you. #medtwitter #orthotwitter #handsurgery #sydney #australia
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Sometimes life is really really hard. Sometimes you need reminding. things can always be worse. This is my “things can always be worse” reminder. #orthotwitter #medtwitter
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Saw this and *actually* laughed out loud. I love my glorious threatre family. One & all. #HammerItOut #KnockItOut #surgery #anaesthesia #HeForShe #ILookLikeASurgeon #family #home #TheWildThings #teamwork
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*Breaking news*. Germany is advising its people to stock up on cheese and sausages. This is their Wurst Käse scenario.
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Simon Fleming. MBBS *FRCS (Tr&Orth)* MSc PhD MAcadMedEd MFSTEd MASE AFHEA FRSA. If you though I was “a creative disruptive threat to the status quo” before, the next 30 years are really going to upset you. Excited for the future…. #medtwitter #orthotwitter #handsurgery #MedEd
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Dear @gmcuk . Please be aware that trainees are being bullied in your name. Dear trainees . Do *not* write this reflection. This is toxic, this is harmful and this is wrong. #MedEd #medtwitter #NHS
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Morning again #London . I’ll be your orthopaedic surgeon today. If possible, stay home. If you have to go out. - pick a safe route. - dress appropriately (suitable shoes/coat etc). - short steps & shuffle (“walk like a penguin!). - no hands in pockets. #londonsnow #orthotwitter
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This is genuine and was sent out to #juniordoctors. Junior doctors who are working in a pandemic, are burnt out and are, for a variety of reasons, getting ill. This is toxic behaviour. This is bullying. This is everything that’s wrong with training. #medtwitter #MedEd.
I’ve heard that once the junior doctors know their sickness will be put on their permanent record, it makes them feel much better !! . 🏥💉☀️
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I work in the busiest Major Trauma Centre in the UK and regularly am part of a team that saves life and limb. Out of hours, I am often the most experienced #orthotwitter surgeon in the hospital/operating room. I am a #juniordoctor. And you are *checks notes* wrong.
@Dr_BellaR Junior doctors don't do life saving surgery, you fraud.
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Was just sent this. This in on a wall. In a hospital. This is the worst kind of thing. So you can hear it in the back, “DO NOT SET YOURSELF ON FIRE TO KEEP OTHER PEOPLE WARM”. #burnout #PTSD #mentalhealth #Wellbeing #NHS #medtwitter #NurseTwitter #MedStudentTwitter #MedEd
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Really?!. REALLY?!. #JuniorDoctorsStrike #JuniorDoctors #medtwitter #Infantilisation #fullpayrestoration
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“The actual suicide rate for doctors has been estimated at between two and five times the general population.”. So when people tell you the job is is causing burnout, PTSD+, moral injury and mental health issues, please shhh & listen. That’s it. #medtwitter #NHS #COVID #Covid19.
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People are watching that “this is how you peel garlic” video like it’s magical magic from the magic room. I give you “other things that are also vaguely handy. ”. Enjoy. You’re welcome.
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Dear @wesstreeting . On behalf of all 🇬🇧 doctors who are currently abroad & deciding whether to return, as well as those who are in the process of leaving…. 1. Make us want to stay.2. Make us want to come back. The #NHS is *not* broken, it was built this way. It needs
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Well, seeing as how we are approx 50% of the entire medical workforce and if you come into my hospital, I’m often the only surgeon there…. …good luck to you sir. I am, of course happy to treat you, regardless of your views. #JuniorDoctors #JuniorDoctorsStrike #MedTwitter #NHS
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So, I’m an official ATLS Instructor. Also, passed FRCS Part 1. Part 2 in 10 weeks, so back to work!. #orthotwitter #medtwitter
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Tell me you work in the #NHS without telling me you work in the NHS. Yes. Picture taken today. #MedTwitter
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I have questions. But mostly, I’d like to say, this paper makes me very uncomfortable. #MedEd #IAmThe25Percent #medtwitter
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Dear Medical Schools/NHS Trusts. In this case, Leeds. Please reflect on what it says about your core values when you try to use #MedStudentTwitter to undermine #juniordoctors . £11.11 🥲. Sigh. Or just get in the sea. Whatever. #MedTwitter #juniorDoctorStrike #medstudent #NHS
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“What is your favourite bone?. The one I get to operate on”. @DGlaucomflecken is flawless. #orthotwitter #MedEd
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That’s Mr Dr Fleming now. Or maybe Dr Mr. Or Dr². 🤷🏻♂️. #phd #phdpositive #orthotwitter #MedEd #PhD #phdlife #phdchat #AcademicTwitter #medtwitter
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Ignore all previous posts. We have a winner. #dollypartonchallenge #IfYouDontGetItIDontCare
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Dear 🇦🇺 🇳🇿 . Some news (which I hadn’t shared details of, for fear of jinxing it, but booked flights now!). I’m joining the #handsurgery team at Royal North Shore Hospital in #Sydney from August for my fellowship. So. …see y’all soon! . #medtwitter #orthotwitter @RACSurgeons
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Just got a post-manipulation CT of a nasty distal radius fracture. The radiologist has reported:. “impressively, the distal radial ulnar joint and radiocarpal alignment is now near anatomical”. This may be the nicest thing anyone has ever said to me. #medtwitter #orthotwitter
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Hugely disagree with the last speaker - “resilience training” doesn’t change culture or reduce bullying. It simply gives people strategies to cope with them. “You need to be more resilient when I undermine you”. Symptom treatment,not disease cure. #HammerItOut. #LetsRemoveIt.
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“If you suffered in life and want others to suffer as you did because “you turned out fine”, you did not, in fact, turn out fine”. @GeeMcLachlan & I wrote something about the “back in my day” phenomenon seen (and sometimes published) in #surgery & #MedEd .
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To those in 🇬🇧 who just found out they’re going to be trainees in #orthopedics, I say “CONGRATULATIONS & WELCOME”. To those with less good news, I say “I failed my A-levels,my MRCS & my 1st go at getting into ortho.All the best people have a cocked up more than they’ve succeeded”.
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Just a bit of a #factcheck. I qualified med school in 2006. I have a PhD, FRCS, have a global reputation for what I do, & have a family. I am a #juniordoctor. Any media trying to suggest it’s just #medstudents or #juniordoctors in their first year or two is *checks notes* wrong
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Hey @British_Airways . You’ve cancelled my flights in October. They still exist on your website, just at x7 the price. I’ve been on hold for an hour now. This is entirely unacceptable.
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“When all you've ever known is privilege, equality feels like oppression”. If you are about to read 👇🏻this👇🏻 be aware you will be sick in your brain. With rage. This can get in the sea. Happy #IWD2023. #MedTwitter #MedEd #JuniorDoctors #MedStudentTwitter #patriarchy
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I have my 1st list where I am “the surgeon name at the end of the bed” tomorrow. I’ve designed the list around training. I’ve facilitated an SpR & SHO to be there. I’ve given them list in advance, clarified what they can expect to see/learn/do & what I expect. #medtwitter #MedEd
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None of us want to strike. 📈#medschool *debt*= £90-150,000. 📈personal *cost* of training= £25-100,000. 📉our salary. 📈 mental/physical trauma from infantilisation, no respect & pandemic= priceless. time to pay #juniordoctors what we’re worth. #JuniorDoctorsStrike #medtwitter
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Today and tomorrow, the operating surgeon will be…erm…me. I’m a #juniordoctor & have been since *checks notes* 2006. We need to value our #healthcare staff. We really won’t know what we have lost until it’s gone. #juniordoctors #JuniorDoctorsStrike #medtwitter #orthotwitter
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It’s only Tuesday and everything is a bit much so…. …penguins
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Excellent ‘script’ from the @TheBMA on how to address the usual toxic attitudes & bullying that emerges when asked to work non-contract hours. It may be for @BMA_Consultants but I’ve used these & similar when pressured to work outside my hours. Share far and wide #medtwitter!
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🚨 #NHS Consultants’ ballot PASSES with a 71% turnout & 86% yes vote!* 🚨 . Consultants will *strike* on the 20th-21st July 2023 for the first time in history. #medtwitter #doctor #NHSCrisis #NHS75 #juniordoctors #consultants
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Erm…literally everything. As an on-call hand/wrist/nerve/ortho surgeon, here’s a sentence I shouldn’t have to say:. “Don’t jump off cliffs, into bodies of freezing water, while holding axes”. #orthotwitter #medtwitter.
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Letter of support from the #orthotwitter bosses at @NHSBartsHealth, @BHRUT_NHS, @NHSHomerton . #juniordoctors - it’s time to vote. Check your post & return your ballot. #medtwitter #NHSStrikes #NHS #PayRestoration #BMABallotReady
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Some complaining about this. To them I say “when you're accustomed to privilege, equality feels like oppression”. #MedTwitter #surgery.
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To those who ask me how to cope w/ failure. I’ve failed more times than I’ve succeeded. failed my A-levels .failed my MRCS (both bits,both times).failed my friends,family & loved ones. Keep going,keep trying & learn. Failure is feedback & feedback is the breakfast of champions
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Today’s teachable moment. If you are MANIPULATING patients with Ank Spond, there is an entire profession that will stand opposite you in court to explain why what you did was “a bit murdery”. #orthotwitter #medtwitter
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£108,000 for undergraduate medical degree in 🇬🇧. Now add the cost of postgraduate training (£20-100,000). Now add all the other costs. The psychological, the social, the physical. Now add a culture that makes *you* feel worthless. we need to change!. #HammerItOut #ChangeTheNorm.
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I still get nightmares about suddenly being told I really failed FRCS (again). I can’t get over the absolute horror of the current MRCP fiasco . 🇬🇧 medicine/surgery + training are in a rapid downward spiral and the lack of insight by so many is the reddest of red flags.
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Today, while speaking to some aspiring #orthotwitter surgeons, I was asked if there’s ever a time we collaborate with general #surgery or urology. Now, I could have talked about spine or pelvis but instead I present…. “Femoral-Head Dislocation to the Scrotum”. #Medtwitter
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Uh oh. New addition to this tweet 👇🏻👇🏻👇🏻. When *Twitter*, this twitter, right now, pulls you up for #fakenews, you know things aren’t right. #medtwitter #factcheck #JuniorDoctorsStrikes.
The BMA has demanded a 35% pay rise for junior doctors. Here's their current average pay rates at different levels.
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The 2020 competition ratios for 🇬🇧 . #medtwitter #orthotwitter #surgery #surgtwitter #COVID #COVID19 #NHS
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On behalf of all trauma services, I endorse this knife defence technique. #surgery #orthotwitter #military.
Lesson for the Day: Navy SEAL demonstrates Knife Defense, Totally Unarmed
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Where are you from?.Manchester. No. Where are you *from*?.Manchester. NO. WHERE WERE YOU BORN?. STILL. BLOODY. MANCHESTER. #HammerItOut #ARM2018 #everydayracism #BME #ILookLikeASurgeon #equity #equality #racism
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You know they say “never meet your heroes…”. Tosh. Definitely meet them. Especially if they’re @DGlaucomflecken . Absolutely glorious human, comedian, advocate & educator. #WeAreAllBill . #ICRE2021 #MedEd #medtwitter #orthotwitter
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If you have #medstudents in your OR and aren’t getting them scrubbed and doing stuff, you probs shouldn’t have #medstudents in your OR. That’s the tweet. #orthotwitter #surgery #MedEd.
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