🗞️ This Week In Medicine Summed Up

🗣 Hear ye, hear ye!

Gather round, ye weary residents and assorted healers of the realm, for the Handover hath arrived once more!

Behold, tidings from the government, new research and royal scandal … all delivered in your weekly email scroll 

Read on, brave one: the kingdom needs ye informed 🏰

👋 Happy Friday. Here’s what we got:

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

There are a few things guaranteed to cause disagreement amongst doctors.

Which speciality is the smartest?
Should you put your fav scrub selfie on Hinge?
How to pronounce cervical?

And now, skyrocketing to the top of the list:

The new resident doctor offers. 

After weeks of negotiations, the planned 5-day strike action was called off at the eleventh hour on Saturday night, leaving a few overly hopeful docs unpacking their Ryanair carry-ons in despair. 

Group chats flooded with AI messages?
Medfluencers on your FYP with different hot takes?

Confused at what’s actually going on?

You’re in the right place. Here’s the breakdown of all you need to know:

💰 Pay 

The figure featured in all the headlines this week is the promised average pay uplift of 6.6% by April 2027. 

But crucially, this isn’t one lump sum. It’s a combination of the following: 

*DDRB = Review Body on Doctors’ and Dentists’ Remuneration. The independent review body that makes annual pay recommendations to the gov, separate to strike action. 

So what does nodal reform actually mean?

Essentially, as you move through resident doctor training, you progress up nodal points like rungs on a ladder. Each rung you climb, you get a small pay boost. Neat.

Sadly, not every year survived as a doctor means moving up another rung.
Going from ST1 to ST2, for example, doesn’t actually give you a bump in salary, despite the career progression you’re making. 

But with the new offer, more nodal points are being introduced, i.e. more rungs are being added to the ladder. 

So there would be a pay rise every year of progression, whereas currently there are no rises between ST1 and ST2, ST3-5 and ST6-8.

Here’s the full breakdown: 

But not every node is getting an extra pay rise.

ST3s and ST6s, for example, would ONLY receive the 3.5% from the DDRB. Nothing from this new offer.

So the overall additional average uplift from the deal is approximately 3.1% through nodal reform, phased in gradually over the next 10 months. 

💼 Jobs 

In a bid to address the post-F2 career limbo, where thousands of resident doctors get stuck trying to progress, the government has pledged to create an extra 4,500 speciality training posts. 

Importantly, this isn’t an immediate change, but is spread over the next 3 years: 1,000 this year, up to 1,750 in 2027 and up to 1,750 in 2028.

Here’s what we know so far:

📚 Other Pledges

For Locally Employed Doctors (LEDs), i.e. doctors not on standard training contracts:

For less-than-full-time (LTFT) doctors:

Extras:

The vote opened to BMA members yesterday and closes next Friday at midday. 

It’s a deal or no deal, with the latter meaning an increase in strike intensity. 

Should we accept?
Only you can decide 🤔

Want to read more? Check out the full offer here

After years of study, researchers out of the prestigious University of Handovia have finally adapted the Technology Adoption Cycle to the healthcare setting.

Stage 1 is Innovators That Weird-Ass Reg in Your MDT

Jamie’s gone off again.
Last year it was NFTs. Then memecoins.
Now it’s this “GPT for doctors” thing.
You roll your eyes.

Stage 2: Early Adopter Did You Hear He’s Really Clever Now?

Suddenly Jamie’s… useful.
He’s quoting NICE guidelines published last week and referencing trust guidelines like their trending on Twitter. The consultant loves him. The whole team loves him.
What the hell happened???

Stage 3-4: How Bad Could it Be?

You crack.
What was that site again?
It’s called Medwise.ai

It’s like ChatGPT but force-fed every NICE guideline, society consensus statement, and Royal College publication until it begged for mercy.

You type in a question and bam.
Evidence-based answers. 
NICE-aligned. Instantly cited.
No more PDF trawling. No more second-guessing. No more paging Jamie.

And apparently, it’s already used by over 1,000 NHS organisations.

So avoid becoming a Stage 5 Laggard and try Medwise.ai today  
And if you sign up with your NHS email, you’ll get access completely free.

Check it out with the link below 👇

Ah, vitamin C, so versatile, so useful. You can do so much with:

Is there anything it can’t do?

Did you know it's even used for... burns?  

Who would've thought you'd be getting the hottest drip (IV) because you decided to put lighter fluid on the coals at your weekend BBQ? This was not what Ellie Goulding meant when she said You gotta let it burn.  

For years, intravenous vitamin C has been used in some burn centres for patients with severe burns covering more than 20% of their body surface area. 

The theory is pretty sensible: vitamin C may help protect blood vessels, reduce fluid leakage, dampen inflammation and support wound healing.

The VICTORY trial by JAMA investigated whether IV Vitamin C actually has a role in burn care.

This double blind RCT was conducted across 24 burn centres around the world and turns out Vitamin C as a treatment might have to be 🎶 in a burning pile 🎶 …

Vitamin C also didn't improve the study's primary outcome: the number of days patients were alive and out of the hospital within 90 days of injury.

In fact, things went so poorly that the trial was stopped early after an interim analysis suggested the treatment was unlikely to help and might even be causing harm. 

Overall, an interesting study, but I wouldn't say we 🎶gotta party like the roofs on fire 🎶 just yet. 

For now, though, maybe ease off the BBQs, or at least the lighter fluid.

It’s fair to say AI has taken over the internet.

Maybe you’re a puritan who refuses to touch it and diligently adds ‘minus ai’ to the end of all your Google searches. Good for you.

Or maybe it’s become your everyday crutch, from email responder to AI fruit entertainer. 

Maybe you’ve even used it in a medical context.

Research gathering, explaining concepts, even OSCE practice if you’ve got no mates to hand. 

And over the past few years, a whole ecosystem of specialist medical AI tools has emerged, promising something the generic ChatGPTs and Claudes can’t: clinical expertise.

The logic seems sound. If a chatbot is trained specifically for healthcare, surely it should outperform a general-purpose AI that spends half its time acting as a girlfriend/therapist/yes man to half the population.

Right?

Well, maybe not.

Published in Nature Medicine this week, researchers investigated whether AI tools marketed to clinicians actually did any better compared to general LLMs. 

They used a range of tests from USMLE-style questions to clinical scenarios submitted by actual doctors to test 2 teams of AI bots:

12 clinicians blindly scored the responses. Here’s what they found:

In other words, the fancy specialist clinical AI tools were less medically accurate. 

It’s tricky to conduct robust studies on AI, with variability between browsers, hallucinations and inter-rating between clinicians on questions only being moderate. 

But it’s the first study to challenge the assumption that AI built specifically for doctors is more medically accurate or reliable.

So, time to do away with notions of clinical LLM tools being better than the rest.

Turns out the same bots drafting your situationship's breakup message are also better at clinical reasoning than the tools built specifically for it. Humbling stuff.

💉HPV Vaccine Drives Cervical Cancer Deaths to Zero

Published this week in the Lancet, a new analysis has shown that for women who received the HPV vaccine aged 12-13, no cervical cancer deaths were recorded between 2020 and 2024. 

This is compared to the predicted 23 deaths that might have occurred without the vaccination program based on historical trends. An estimated 200 total deaths have been prevented in England thanks to the national programme.

So even if getting jabbed during PE back in Year 9 wasn't exactly the highlight of your week (or your school was anything like mine, and ‘punch the vaccinated arm’ somehow became a game), it's pretty incredible what these programmes can achieve.

🧬 New Immune Therapy Promises Lupus Remission

A new trial by UCLH and the NHS is using immunotherapy to treat lupus, with five patients suffering from a treatment-resistant form of the disease entering remission.

The therapy uses genetically modified CAR-T cells to wipe out pathogenic B cells. Then allow the immune system to repopulate with new, well-behaved B cells.

The early results have been impressive. Five of the first six patients treated entered remission within months, with improvements seen in both symptoms and blood markers of disease activity.

For patients with lupus nephritis, the findings were particularly encouraging. Several saw kidney function improve and protein levels in their urine fall, offering hope for a condition that can otherwise lead to permanent organ damage.

The trial is still ongoing, and larger studies will be needed. But it seems immunotherapy is the biggest hope for these types of diseases in the future, so watch this space 👀

👑 A Royally Big Breach of Privacy

In what can only be described as a truly terrible plan, a former healthcare worker has been formally cautioned after attempting to disclose the Princess of Wales' medical records for financial gain whilst she was a patient at the London Clinic in 2024. 

The Information Commissioner's Office described the incident as a "clear breach of trust" involving the deliberate misuse of highly sensitive personal information. The investigation found no fault with the hospital itself. 

As it turns out, trying to monetise the medical records of the future queen was not, in fact, the best career move.
Who could’ve guessed?

Handover Over 🫡

If you liked it, tell your mates
(forward along, please. It only takes 12 seconds, making this took 12 hours.)
If you hated it, tell your enemies.

Week 2 of The Handover FIGs Scrub giveaway

The top referrer for the Handover at the end of July will get a free pair of FIGs scrubs.

Our top referrer is 28 referrals so far. There are still 3 weeks of the challenge left. That’s 10 a week to win it.

Reckon you can do it?
Use your personal referral link below 👇

Each week I’ll announce who’s top of the list, and how many referral they made.

N.B. Referral gotta be nhs.net, doctors.net or university email address. Referral requires double opt in verification, so tell your mates to check their email after they sign up!

Good luck

Before you depart(if you haven’t voted already), please let us know your role in the poll below.