iiinova — where your digital self keeps evolving

Duncan McGregor @drdmcgregor.bsky.social · 25/09/2026

Given the recent rigmarole and U-turn on what constitutes a breach with respect to doctors’ education and reflection, I wonder whether organisations are planning on guidance to support doctors avoid being reprimanded for engaging in appropriate follow up required for reflection and development?

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Duncan McGregor @drdmcgregor.bsky.social · 22/09/2026

Interesting. Appreciate its American recommendations, but moderate strength of evidence and a strong recommendation in favour of fascial plane blocks for laparoscopic abdominal surgery from the ASA. Is the TAP block going to make a comeback? www.ovid.com/jnls/anesthe...

ovid.com

2026 American Society of Anesthesiologists... : Anesthesiology

This practice guideline addresses perioperative pain management using local and regional anesthesia for cardiothoracic, mastectomy, and abdominal...

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Duncan McGregor @drdmcgregor.bsky.social · 31/08/2026

I can only assume this was as some cruel and unusual punishment for somebody intubating a bedbound care home resident overnight?

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Duncan McGregor @drdmcgregor.bsky.social · 31/08/2026

‘Weekend’ is a bit of a misnomer here no?

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Duncan McGregor @drdmcgregor.bsky.social · 15/08/2026

I can tell you what happens when a bunch of people have been in ED through the night and slowly get signal through during the following day

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Duncan McGregor @drdmcgregor.bsky.social · 14/08/2026

Open abdomen falls into this category for me

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Duncan McGregor @drdmcgregor.bsky.social · 09/08/2026

Often it is easier when there is a bit of a gridlock just to say we’ll have to get the bosses to thrash it out between themselves. Anaes/ICM are privileged as you say in that there is an expectation to be called

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Duncan McGregor @drdmcgregor.bsky.social · 16/07/2026

To be honest it is the case in every trust I’ve worked in. Yet to work somewhere where I am seeing it commented on more than very occasionally

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Duncan McGregor @drdmcgregor.bsky.social · 16/07/2026

I’ll be honest, I’d just be thrilled to see reports routinely commenting on whether there is evidence of diastolic dysfunction or not as a baseline expectation

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Duncan McGregor @drdmcgregor.bsky.social · 16/07/2026

Sorry a tad tongue in cheek there. But very interest context thank you. Appreciate the breakdown of categories. Good to know that my bug bear about this is backed up by national guidelines though

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Duncan McGregor @drdmcgregor.bsky.social · 16/07/2026

And that information is clinically important, even if you can’t pin down a useful number or severity category in the same sense you can with LVSD

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Duncan McGregor @drdmcgregor.bsky.social · 16/07/2026

Appreciate the challenges associated with correlated echocardiographic findings with validated, clinically-important prognostication. However as you say it is not uncommon to have echos reported as normal LV function when reading between the lines there is obviously diastolic impairment

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Duncan McGregor @drdmcgregor.bsky.social · 16/07/2026

So essentially the answer to my question is laziness?

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Duncan McGregor @drdmcgregor.bsky.social · 16/07/2026

I’ve come across multiple reports of echos for ?failure with atrial enlargement, LVH, normal or supranormal EF and none of the diastology done.

static.klipy.com

Dipper Pines: This Is Worthless! (Gravity Falls)

Alt: Dipper Pines: This Is Worthless! (Gravity Falls)

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Duncan McGregor @drdmcgregor.bsky.social · 16/07/2026

I appreciate it is a faff and not needed as part of a routine examination of every patient. But I come across so many echo reports where the indication was assessment of likely heart failure and the finding of normal EF doesn’t seem to prompt assessment of diastolic function.

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Duncan McGregor @drdmcgregor.bsky.social · 16/07/2026

Okay Cariology/Echo people. Why is it that: 1. Diastolic function is so rarely undertaken as part of investigation of failure symptoms? 2. When it is undertaken it is almost never reported with severity grading?

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Duncan McGregor @drdmcgregor.bsky.social · 15/07/2026

Friends have been confiscating his scissors for fear of the integrity of his remaining t shirts

A selfie in a tank top and tiny little shorts

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Duncan McGregor @drdmcgregor.bsky.social · 09/07/2026

From the people who voted for Boaty McBoatface, we have now an opportunity to do something spectacular

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Duncan McGregor @drdmcgregor.bsky.social · 16/06/2026

I am not convinced that this is a reasonable requirement in all instances

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Duncan McGregor @drdmcgregor.bsky.social · 16/06/2026

And how many years have you been that now?

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Duncan McGregor @drdmcgregor.bsky.social · 16/06/2026

I think more so than communicating experience, it is more important that is is about communicating responsibility. If an SHO is referring a patient to ICU, they may be perfectly competent to do so. But I also want to know that a clinician with senior responsibility has been involved

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Duncan McGregor @drdmcgregor.bsky.social · 16/06/2026

It’s bonkers. Like I appreciate that it is a blunt tool and doesn’t accurately capture the difference between say a brand new F2 and an end of year IMT2 who are on the same rota. But the obsession with completely trashing broad rota tier names is frankly impractical nonsense

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Reposted by Duncan McGregor

Amy @lolennui.bsky.social · 12/06/2026

guy has a trillion dollars, 0 friends, and has never landed a joke. I know a pact with the devil when I see one.

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Reposted by Duncan McGregor

Lewis Goodall @lewisgoodall.com · 12/06/2026

Musk as a trillionaire- anyone as a trillionaire- is a grotesque economic, moral and political problem. We cannot have individuals with that level of power, whatever they might have achieved.

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Reposted by Duncan McGregor

Neil Pickles @neilrpickles.bsky.social · 12/06/2026

If ever there was an argument for a wealth tax, this trillionaire business is about as good an argument as there could ever be. There’s vulgar wealth and then that

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Duncan McGregor @drdmcgregor.bsky.social · 17/05/2026

I miss it too. Watched last year and didn’t feel good about it, this year have boycotted properly and it feels like Christmas is cancelled 😭

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Reposted by Duncan McGregor

Russell 🏳️‍🌈 @medicrussell.bsky.social · 07/05/2026

The worst thing about UK politics is when I read the policies I probably align with the Lib Dems the most but it’s such a cuck move isn’t it? Like going to a restaurant for pasta with tomato sauce? Anyway #VoteGreen 💚

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Duncan McGregor @drdmcgregor.bsky.social · 01/05/2026

Mhmm just wanted to post a photo of the lamp for the internet to see

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Duncan McGregor @drdmcgregor.bsky.social · 12/04/2026

Anyone with a #studentloan that wants to tell the government how you feel about it (cough cough exploitative) there is a treasury survey running until the 14th so please submit your thoughts! forms.office.com/Pages/Respon...

forms.office.com

Microsoft Forms

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Duncan McGregor @drdmcgregor.bsky.social · 06/04/2026

Do you also demonstrate the crippling effect of the octopus extension on a decent cannula?

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Duncan McGregor @drdmcgregor.bsky.social · 06/04/2026

Of course you admire the sentiment you’re the one that said it! Probably is, but much less fun that way

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Duncan McGregor @drdmcgregor.bsky.social · 06/04/2026

I’m fairly sure I have. This is the one that ends along the lines of a PA sheath, a three way tap and a 50ml syringe is the quickest way to get volume in to a human

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Duncan McGregor @drdmcgregor.bsky.social · 06/04/2026

I think that there are aspects of the basic sciences that are helpful when they can be made clinically relevant. One of my fav topics for students and foundation doctors is running through first principles of cardiac output physiology and applying to decision-making for low BP management

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Reposted by Duncan McGregor

Gavan Reilly @gavreilly.com · 05/04/2026

I’m beginning to think he’s dragging the FIFA Peace Prize into disrepute.

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Duncan McGregor @drdmcgregor.bsky.social · 05/04/2026

And while I think that some compromise of pay and conditions would be reasonable, the downside of the union taking the easy path re-messaging and demands is that there is a very large and very vocal cohort that will accept nothing short of FPR

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Duncan McGregor @drdmcgregor.bsky.social · 05/04/2026

Yeah I think that pay is the easiest banner to rally behind, it’s a clear message to say “we’re not paid enough for this shit”, whereas its much harder for a union to pull together a series of demands to make working life better for a group that have varied work environments and challenges.

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Duncan McGregor @drdmcgregor.bsky.social · 05/04/2026

This was of course me being a little shit, as is my prerogative

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Duncan McGregor @drdmcgregor.bsky.social · 05/04/2026

I think that this hits the crux of it. The UK job market for medics is not subject to market forces while the international landscape is. Yes there are a significant number who have ties that overcome the international draw, but not enough to make the international competition insignificant

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Duncan McGregor @drdmcgregor.bsky.social · 05/04/2026

I have personally verified that this is a real post

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Duncan McGregor @drdmcgregor.bsky.social · 05/04/2026

One of the most unironically funny things I’ve read. I’m in bits

Screenshot of a tweet from a total maniac which reads “Tuesday will be Power Plant Day, and Bridge Day, all wrapped up in one, in Iran.
There will be nothing like it!!! Open the Fuckin' Strait, you crazy bastards, or you'll be living in Hell - JUST WATCH! Praise be to Allah. President DONALD J. TRUMP”

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Duncan McGregor @drdmcgregor.bsky.social · 05/04/2026

Yeah not exactly the shining example of imparting sage wisdom or cultivation of educational growth so much as a series of exasperatedly conveyed pet peeves and tenuously linked anecdotes. Plenty of time for coffee though so swings and roundabouts.

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