A Day in a life of a FACEM

23 03 2019

Most of us would be excited that SMACC is next week !

It is the last SMACC after all !

I have now been working as a consultant for the last 1 year !

Impostor syndrome occasionally prevails and pervades my ability to perform.


Sometimes I fumble upon describing a pelvis Xray accurately – fumbling the words “sacro-iliac” or “sub-trochanteric”

In moments of stress or high tension ; I would often default to :

a. the ZERO Point survey – espoused by the famous Dr Cliff Reid at Resus.me






15 07 2018

I am now a FACEM. This is a long journey which started in the corridors of an emergency department.

I am now doing WBAs fr trainees instead of doing them with with other consultants.


I credit influential mentors and a great hospital system for influencing me.

The whole idea that I am now a specialist…is scary.

Sometimes I wonder, whether my behaviour and leadership example is appropriate for a  consultant. I can only continue to strive for my best. every day.

For the patients.


cases from 29th December 2017

30 12 2017

a lysed inferoposterior stemi…

an MTP joint aspiration…

4th MCP fracture > POSI

droperidol x3….

haemarthrosis knee

superior articular facet fracture of c7….




21 12 2017

noun: counter-transference
  1. the emotional reaction of the analyst to the subject’s contribution.


i thought i was okay; until someone asked whether “are you okay”

and reminded me that “i am awesome”

maybe i display a flat face when it comes to feedback

but deep deep down i feel guilty and stupid

and always blame myself for not being good enough

not failing to be a patient advocate



on another gripe

i have a theory that registrars of similar ethnic backgrounds treat each other like shit. just an observation. “can’t be accused of racism” right


The osces…done !

1 09 2017

Passed the osces !

this empty feeling remains….. I wonder why.

The night before the OSCE

18 07 2017

it is 14 hours to the OSCEs.

I sit here in this nice, sparkly clean apartment with my laptop on my thighs. Notes / books scattered on tables/floors.

The shirt/scrubs are ironed / hung on hangers….

The shoes ready. Next to the door.

People tell me that I am ready. I don’t. I really am not.

I had a rough few weeks. Personal matters.

For the first time in my life, I have actually thought about suicide. It is real. What if ?

Don’t worry (I have more reasons to live)

Just goes to show that even myself am not immune to these thoughts. Suicide is real. Depression is real. I used to think that people on anti-depressants don’t necessary need to be on them …..


I had few encouraging emails from old bosses :

the most encouraging one was “good luck” but the truth is “you don’t need any more luck”
“you are a FACEM”



now….to try and remember that we actually measure thrombin time for dabigatran and now Xa levels….

or which is Neer’s test again. or Hawkins. or Mcmurrays…

Look. Feel . MRI !



T-9 days to FACEM Fellowship OSCEs

9 07 2017

It is 9 days… to the 3 day extravaganza they call the “ACEM Fellowship OSCE Exam”

I have 2 more work days ; so that makes is to 7 days.

7 days to practice :

101 ways of taking various history and exam i.e. headaches/abdo pain/chest pain/syncope

dozens of various physical exams e.g. cardiovascular exam / knee exam

dozens of data interpretation

Hundreds of variants of Simulation scenarios

Dozens of communication practices


Hang..on..I should have practiced them for the last 4 years !




The nerves are getting to me. Silently.