iiinova — where your digital self keeps evolving

Paul McCoubrie @pmccoubrie.bsky.social · 12/08/2026

Few snaps of tonight’s partial eclipse. We got about 92% here in the UK 400mm lens, heavily cropped, manually exposed with big stopper filter (ND1000)

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Paul McCoubrie @pmccoubrie.bsky.social · 15/07/2026

Doing my last on-call tonight. Off the radiology on-call rota after 26 years I’ve jinxed it now, haven’t I? It’s going to be a shocker.

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BJS Academy @bjsacademy.bsky.social · 05/07/2026

🐺 When every scan is flagged as urgent… is anything really urgent? In the latest instalment of his popular series 'A view from the dark side', radiologist Dr Paul McCoubrie explores how alert fatigue, defensive reporting, and inbox overload create unintended risks 🔗 buff.ly/LRAUKtL #surgsky

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Paul McCoubrie @pmccoubrie.bsky.social · 03/07/2026

St Jakob’s, Ortesi, Italian Dolomites. We climbed up the 3km steep path out of town but turns out there is a bus that takes you 7/8ths of the way I lugged my big Nikon all the way but it does have very good colours

A scenic church (St Jakob’s) in the Dolomites just outside Ortesi. Evening light, cloudless blue sky with woods and steep mountains in the background

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AJ Jefferies @moonjam.com · 30/05/2026

Hey! It is my BIRTHDAY today and I am OLD. I know that most people will be outside, enjoying life BUT should you choose to shackle yourself to a screen instead, why not check out/share/re-watch/rate/review/shout at my film DUCKS? www.youtube.com/watch?v=L8vZ... ko-fi.com/moonjam 🎂🦆🍞🦆🎂

youtube.com

DUCKS | Award Winning Animated Short Film (2025)

YouTube video by AJ Jefferies

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Paul McCoubrie @pmccoubrie.bsky.social · 06/04/2026

My wife bought this book recently and I was disappointed to find out it was nothing to do with long exposure radiographs

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Paul McCoubrie @pmccoubrie.bsky.social · 28/03/2026

Quiz time. Have a look at this xray of a smöl child’s forearm. They hurt it playing football; falling on an outstretched hand (FOOSH) What do you see? Answer in 24hrs

X-ray of a child’s forearm showing an injury

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Paul McCoubrie @pmccoubrie.bsky.social · 12/03/2026

Nice to see it isn’t just radiologists that make VR howlers

A pathology report that reads ‘bladder tumour - multiple chickens together measuring 10mm’ (should be chippings)

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Paul McCoubrie @pmccoubrie.bsky.social · 04/03/2026

A snippet from today A hapless colleague was described today as having the ‘Casanova touch’ “Everything he touches, he f*cks” I cackled

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BJS Academy @bjsacademy.bsky.social · 02/03/2026

🏆ARTICLE OF THE MONTH: All roads lead to outsourcing ➡️ buff.ly/EjI95dt With demand rising, workforce gaps widening, and costs escalating, is outsourcing a solution — or a symptom? @pmccoubrie.bsky.social takes on the realities behind outsourced radiology #medsky #surgsky

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Paul McCoubrie @pmccoubrie.bsky.social · 26/02/2026

Any radiologists on here? If so, are any are going to ECR 2026 in vienna next week? Might see you there. Particularly if you come to this session, a rollercoaster of a session - perfectly serious insights wrapped up in a cloak of humour.

A screenshot of my ECR 26 session in Vienna in early march 2026 where I will be giving two back to back lectures about actionable reporting

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Paul McCoubrie @pmccoubrie.bsky.social · 21/02/2026

If there was ever a t-shirt for radiologists, this is it

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AuntMinnieEurope @auntminnieeurope.bsky.social · 17/02/2026

Overcalls and unnecessary hedging by younger #teleradiology doctors must be tackled if we're to solve the problem of sub-standard reporting, says @pmccoubrie.bsky.social. buff.ly/VmAHcNe #Radiology #outsourcing

buff.ly

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Paul McCoubrie @pmccoubrie.bsky.social · 12/02/2026

As ever, my intentions are perfectly serious, clothed in humour

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Paul McCoubrie @pmccoubrie.bsky.social · 23/01/2026

From one my regular correspondents: “Evidence of pacemaker” Isn’t it beautifully awful?

A radiology report with the words ‘evidence of pacemaker’ highlighted

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Paul McCoubrie @pmccoubrie.bsky.social · 20/01/2026

The first FRCR anatomy exam is fast approaching. Test your knowledge against this seemingly innocuous annotated abdominal radiograph. Answers in a week

An annotated abdominal radiograph with lots of normal structures lablled A-S

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Paul McCoubrie @pmccoubrie.bsky.social · 19/01/2026

Send by a radiologist pal. Fancy being met on a Monday morning by this horrific sight

A medical grade £5k 30” PACS monitor that has been cleaned very poorly, leaving massive streaks and dribble marks

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Paul McCoubrie @pmccoubrie.bsky.social · 12/01/2026

Low incidence problems are the heartsink of radiologists across the globe. But they are everyone’s problem. Including the patient.

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Paul McCoubrie @pmccoubrie.bsky.social · 21/12/2025

A neighbour left a festive present of some mistletoe on our doorstep, clearly well intentioned and seasonally appropriate Yet I can’t help thinking that mistletoe is a parasite and therefore an odd choice Imagine if I left a gift of a bucket of tapeworms on their doorstep

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Paul McCoubrie @pmccoubrie.bsky.social · 18/12/2025

This topic, whilst not sexy in a *traditional* way, is a modern phenomenon in medical practice. And no one is talking about it

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AuntMinnieEurope @auntminnieeurope.bsky.social · 16/12/2025

In the absence of a magical fairy godmother, we need to take charge of our own work patterns and look after each other to reduce burnout and boost morale, writes @pmccoubrie.bsky.social in a festive column. buff.ly/q6Ee5nr #radiology

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Paul McCoubrie @pmccoubrie.bsky.social · 15/12/2025

🚨*self publicity klaxon*🚨 There is £6 off my books for the festive period. I’d say they’d make a perfect present for radiologists (and those that deal with radiologists) If you live in the UK, DM me for a signed & dedicated copy link.springer.com/book/10.1007... link.springer.com/book/10.1007...

link.springer.com

The Rules of Radiology

This book gets to the heart of what radiology is and what radiologists do and focuses on the key areas required for the newly qualified radiologist

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Paul McCoubrie @pmccoubrie.bsky.social · 09/12/2025

An absolute must read (but long read) about how AI is a massive bubble that is being exploited by big business to do us over. And radiologists are first on the list It’s compelling and unarguably true pluralistic.net/2025/12/05/p...

pluralistic.net

Pluralistic: The Reverse-Centaur’s Guide to Criticizing AI (05 Dec 2025) – Pluralistic: Daily links from Cory Doctorow

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AuntMinnieEurope @auntminnieeurope.bsky.social · 25/11/2025

#Multidisciplinaryteam meetings are expensive and time-consuming, and they don’t advance patient care and should be replaced by protocol-driven care and smaller meetings for complex cases, says @pmccoubrie.bsky.social. buff.ly/XzK9gHG #radiology #cancercare

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Paul McCoubrie @pmccoubrie.bsky.social · 23/11/2025

U.K. cancer MDTs need rethinking - recent BMJ piece. All 4000+ radiologists would breathe a massive sigh if someone could. Please and thank you www.bmj.com/content/bmj/...

bmj.com

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Paul McCoubrie @pmccoubrie.bsky.social · 30/10/2025

This one is close my heart. I hope it resonates you

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Paul McCoubrie @pmccoubrie.bsky.social · 22/10/2025

Anyone ever noticed that the big cat bean looks like a nose?

A white furry cat paw with pink beans fully shown

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AuntMinnieEurope @auntminnieeurope.bsky.social · 21/10/2025

Decision-making is central to clinical practice, but no one seems to make decisions now, writes @pmccoubrie.bsky.social in part 2 of his series about interactions between #surgery and #radiology. buff.ly/8sT03Ls

buff.ly

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Paul McCoubrie @pmccoubrie.bsky.social · 20/10/2025

Out on a walk? Look down as well as up. It’s fungi season in the Northern Hemisphere. These are all sheathed woodtuft #mushroommonday

A whole host of Sheathed woodtuft (Kuehneromyces mutabilis) growing on a tree stump in Ennerdale, UK’s Lake District.

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Paul McCoubrie @pmccoubrie.bsky.social · 09/10/2025

Some sympathy for the teleradiology company. General Medical Council again not fit for purpose. How hard is it to check that an individual is trained and licensed?

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Paul McCoubrie @pmccoubrie.bsky.social · 07/10/2025

Planning our walking holiday to the Lake District next week. Guess which hill we are going up first?

A picture from Wainwright’s North Western Fells of a small hill near Bassenthwaite Lake called ‘Barf’

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Paul McCoubrie @pmccoubrie.bsky.social · 07/10/2025

Storm Amy had an upside this weekend just gone. It was a wet walk in Ingleton but the rivers were very full. Made for some glorious snaps

River Doe in the Yorkshire Dales in full flow, long-exposure effect on iPhone Live Photo

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BJS Academy @bjsacademy.bsky.social · 01/10/2025

🏆ARTICLE OF THE MONTH: Decision paralysis ➡️ www.bjsacademy.com/bjs-academy/... 🏅In this month's most popular read by @pmccoubrie.bsky.social #Radiology #Surgery #medsky #surgsky @bjsurgery.bsky.social @bjsopen.bsky.social #decisions

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AuntMinnieEurope @auntminnieeurope.bsky.social · 30/09/2025

A #ClinicalExam or #physicalassessment lacks sensitivity, but to omit it entirely is short-sighted, writes @pmccoubrie.bsky.social in a new series of articles about interactions between #radiology and #surgery. buff.ly/IG5RAJl

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Paul McCoubrie @pmccoubrie.bsky.social · 09/09/2025

I'm fascinated by decision-making and it's central role in clinical practice. But also it is hard these days and I explore why in my latest column

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BJS Academy @bjsacademy.bsky.social · 01/09/2025

🏆ARTICLE OF THE MONTH: I’m exhausted ➡️https://buff.ly/Jbcg4Bt “These were the words of one of my surgical colleagues as they slumped into a chair next to me one morning. I felt a pang of guilt: they were everything I was not. ” 🏅In this month's most popular read!

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Paul McCoubrie @pmccoubrie.bsky.social · 02/09/2025

I loved this piece by Giles. Glorious. A paradoxical anti-law. Worth 5 mins of your time

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Paul McCoubrie @pmccoubrie.bsky.social · 28/08/2025

A rather fishy radiology request

A radiology request misspelling the word “hearing” as “herring”

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Paul McCoubrie @pmccoubrie.bsky.social · 21/08/2025

Had to have a cold shower this morning - boiler on the Fritz temporarily. Not my usual thing TBH You know how it’s supposed to make you all energised and refreshed? I felt cold. Cold and miserable. And a bit angry 0/10. Would not recommend

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Paul McCoubrie @pmccoubrie.bsky.social · 18/08/2025

Today’s German-compound-word that-we-could-really-use-an-English-equivalent-of Number 238: “Verschlimmbessern” To paradoxically make things worse in honest but failed efforts to make things better See also: NHS reforms of this century

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Paul McCoubrie @pmccoubrie.bsky.social · 05/08/2025

Bit of a game changer for the radiology of incidental adrenal lesions. Fairly compelling argument for (1) doing away with washout CT (2) calling <4cm 10-20HU lesions benign My life may just be about to become a little easier insightsimaging.springeropen.com/articles/10....

insightsimaging.springeropen.com

Washed up: the end of an era for adrenal incidentaloma CT - Insights into Imaging

Abstract For over 20 years, the two key tenets of adrenal incidentaloma (AI) evaluation have been the upper threshold of 10 Hounsfield units (HU) on noncontrast CT (ncCT) to delineate benignity, and t...

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Paul McCoubrie @pmccoubrie.bsky.social · 03/08/2025

Happy #squirrelsunday! This little fellow posed very kindly and I just happened to have my big lens to hand Seen this afternoon in Grizedale Valley, Lake District. Nikon Z8, 400mm, heavily cropped

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Paul McCoubrie @pmccoubrie.bsky.social · 31/07/2025

You can ask me which of my colleagues said this to me but I’ll never blab In truth, it could have been any of them

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Paul McCoubrie @pmccoubrie.bsky.social · 23/07/2025

Sgwd Yr Eira Waterfall in Wales on my old iPhone 11 If you have an iPhone, take a Live Photo then toggle the settings to “Long Exposure”. Bingo. No need for a tripod and dSLR

Long exposure effect picture of a Welsh waterfall, in black and white

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Alan @gammacounter.bsky.social · 24/06/2025

“I was at a national radiology conference four years ago when a consultant surgeon stood up and stated, ‘Clinical examination is dead’. There was a stunned silence for a few moments then hushed murmurs of discontent.” www.bjsacademy.com/bjs-academy/... by @pmccoubrie.bsky.social

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AuntMinnieEurope @auntminnieeurope.bsky.social · 25/06/2025

Tributes are flowing for Prof Barry Kelly from #belfast, a key figure in Irish #radiology. "He was a polymath, effortlessly weaving art, poetry, literature, philosophy, and medicine into mesmerising talks. He was radiology’s Stephen Fry," says @pmccoubrie.bsky.social. buff.ly/R3SxYGA

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BJS Academy @bjsacademy.bsky.social · 23/06/2025

🩻 A new view is here... and it's coming from the dark side... Dr Paul McCoubrie brings you the radiologist's point of view (and kicks off this new series) with 'Clinical examination is dead' ➡️ buff.ly/Ws5HIz7 #surgery @pmccoubrie.bsky.social‬

buff.ly

Clinical examination is dead

I was at a national radiology conference four years ago when a consultant surgeon stood up and stated, âClinical examination is deadâ. There was a stunned silence for a few moments then hushed…

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