🥳The Big Black (Handovian) Friday Sale

Is it just me…or did Black Friday fall off?
Where is the hype?
Where are the full-contact rugby scrums for 80-inch TV’s?
Black eyes, Broken noses & Bennet’s fractures for the good people in A&E to deal with?

The Internet has not just robbed us of good-ass deals, but also a day filled with good-ass fight stories. On behalf of the internet, I apologise. Take this medical news as a peace offering.

👋 Happy Friday. Here’s what we got:

If you want to read any previous editions of The Handover, you can on our website.

“Lavender oil cured my mother’s uncle’s neighbour's dog’s friend’s cancer! I swear, Doc!”

Yeeep, sure thing, Mrs Jones. 

I know for a fact you’ve faced this kind of bogey medicine before, haven't you? 

You probably just screamed internally, nodding along to fast-forward this unskippable cutscene. Or maybe you argued back. I don't judge.¯\_(ツ)_/¯

Suffering through impassioned speeches about apple cider vinegar, St John’s Wart (get that man some bazuka cream STAT) or homoeopathic rubbish is a depressing rite of passage. 

But what if it’s not all snake oil? What if some of it is actually … fish oil?

…

Hear me out. I am so for eel rn. 

The aptly named ♓ PISCES ♓ trial published in NEJM this week set out to investigate if fish oil might actually be of real benefit in lowering cardiovascular risk amongst patients undergoing regular haemodialysis:

Fish oil went head-to-head with corn oil placebo in 1,228 adults on maintenance haemodialysis across Canada and Australia.

Groups? 610 team fish, 618 team corn.
Dosage? Four 1g capsules per day
Follow-up? Over 3.5 years.

“Let minnow what they found!” I hear you yelling at your screen. 

Well, since you begged for it: 

But PISCES isn’t perfect. In fact, most Pisces I know are far from it … (all shade intended)

Still, it’s a cheap, simple intervention that meaningfully reduces catastrophic cardiovascular events in a high-risk patient population. Oil that in a day’s work. 

So maybe Mrs Jones can hang onto her lavender oil for now. Just squeeze a bit of fish in there, too.

And remember, in a world of essential oils, snake oils, and crude oils, it’s time to THINK FISH.

Fin
(yes, every single pun was intended)

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Gather round, Handovians. 
Let me whisper a cautionary tale. A Greek myth, NHS style.

Remember, barely two moons ago, NHS England announced IMT’s brand-new loyalty scheme?

As a refresher: If you apply only to IMT or ACCS-IM speciality training, Felicitations. 5 extra points on the self-assessment scoring.

A seductive offer. A little wink. Essentially emotional blackmail.
Like any good Trojan horse, it looked like a gift.

Well.
Turns out that particular Trojan horse has teeth. 

IMT Rage Bait Disaster

The IMT shortlisting score to get an interview?

Skyrocketed to 22.
Last year? 15.

This means you could have:
– a PhD ✅
– a first-author paper ✅
– a textbook chapter (??Genuinely why) ✅
– a national presentation ✅
– 3+ months of teaching ✅

 …and still no interview.

The loyalty scheme was less a bonus and more exquisitely crafted rage-bait.
There were 8,251 IMT applicants this year, actually down from last year (8,728). 
Yet still the cut-off yeeted itself into the stratosphere.

If you’re not fluent in IMT recruitment lore, dw:

It’s scored out of 30… plus the bonus 5 for monogamous loyalty, so 35. 

That gets you an interview. There are ~4,000 interview slots for ~1,700 IMT places. Do the maths (or not, it’s depressing).

Quick PTSD portfolio points refresher:

Even with all your eggs in one basket, you still needed a higher base score than last year to get an interview. And that’s after pledging yourself to IMT like the NHS equivalent of arranged marriage. 

And if you didn’t sell your soul?
The cut-off was pretty unrealistic unless you have credentials spilling from every orifice.

FY2s? Please.
They’ve been in clinical training for like 12 minutes. They had no chance.

IMT isn’t niche either…
It’s the gateway to basically all medical specialities. Missing it means career limbo. 

But the loyalty scheme meant gambling with unemployment, in an NHS-branded casino.

The BMA Also Said WTF?

The entire executive of the resident doctors’ committee wrote to Sir Jim Mackey, the final boss of NHS England, saying ‘this system is cooked’ - or something like that. 

They confirmed the obvious: Expecting FY2s to hit these scores is delusional, and workforce planning is nonexistent. 

They also made some actionable asks: Stop fraudulent CREST forms (proving NHS experience) for international applicants, and give better study leave so FYs can portfolio farm.

Time to Get the Pitchforks. Who’s Responsible? 

The Physician Speciality Recruitment Office. A faceless, mysterious entity that feels like NHS England’s Death Troopers. Genuinely couldn’t list names if we tried, sorry.

Gutted to be so doom and gloom.
We keep talking about bottlenecks because… they keep bottlenecking.

IMT 2025 is a masterclass in turning a recruitment bottleneck into a Greek tragedy.
If you’re pre-training: deep breaths, hydrate, download Headspace. Or scream into a pillow.

You’ve earned it.

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Strike Mandate To Be Extended

Another round of industrial action concluded last week. The outcome? Nothing but whinging and complaining from the health secretary and his minions. No significant advancement in pay. No significant advancement in jobs. So as this mandate closes, another one could open. From 8th December to 2nd Feb 2026, a new RDC ballot will open, asking its members if they want to go again. If they get the green light, a new mandate that will go until August 2026 will be announced.

Forget Insulin Injections: Insulin Cream FTW

No one likes needles anyway. Forget the jabs and injection site rotation. This experimental design, published in Nature, asks “What if it were possible to take insulin as a cream?”. They attached insulin protein to a skin-permeable polymer that zips past the skin barrier and into the bloodstream. Shown to be effective in lowering glucose in animal models, so there is hope here.

BMA contract negotiations

Another tussle between the Gov and the BMA has emerged this week. The Government will remove the BMA as the sole negotiator of GP contracts - a position held by the BMA since the inception of the NHS. Instead, a pool of individuals, including RCGP, NACP, Healthwatch England and National Voice, will collectively contribute to decision-making. The reason for the change was to “engage with wider primary care stakeholders.” But in reality, it’s because they CBA with the BMA. Ironically, the RCGP want no part in this, so lets see how long it sticks for 

Looks like Quackery, but its not: Tai Chi > CBT?

Is the West going to take another loss to homoeopathic medicine? Now, today, it’s Karate for old people - Tai Chi - being compared to proven Western medication CBT. This study in the BMJ aimed to assess if tai chi was non-inferior to CBT in chronic insomnia of middle-aged people. They found it was worse at 3 months, but non-inferior at 15 months. Perhaps there's some truth to the Zen after all 

Lincoln Medical Students Get Super Realistic “Breathing Mannequins”

And finally, how lucky are these medical students? After a £1.4 million grant, the med students get access to these super cool, super realistic, high-tech training mannequins that will "transform hands-on clinical training for the next generation of medics"

I mean…it’s just uncanny how real it looks. £1.4 million well spent 👏

Handover Over 🫡

If you liked it, tell your mates
(forward along, please. It only takes 11 seconds, making this took 11 hours.)
If you hated it, tell your enemies.

See you this Sunday for another Deep Dive.

Let’s get a bit more granular this week… If you’re a junior doc, tell me. What stage are you?

It always helps in tailoring content to our readership. Thank you 🫶