SJT: Stop Working When You Are Impaired (passthemsra.com) - Free MSRA revision

This episode explores how to recognise impairment, stop safely, escalate early, and apply the GMC’s 2024 guidance under real clinical pressure. It breaks down the red flags, traps, governance steps, and the REST SAFE framework so you can act decisively and protect patient safety. A clear, exam-focused deep dive for the MSRA SJT.0:00 Setting the scene00:22 Near-miss and microsleeps00:48 Why this is a high-stakes moment01:10 Impairment definition and GMC duties01:46 Patient-first principles02:35 Action over intention02:58 Three-step safety logic03:44 Psychological barriers to escalation04:28 Red flags for mandatory stopping05:09 Public-safety risks05:37 Trap answers and cognitive biases06:26 Why delay always loses06:52 REST SAFE introduction07:20 REST — immediate safety steps08:10 SAFE — governance and recovery09:00 Model phrases for escalation09:48 Difficult scenarios (no cover, mid-consult)10:38 Too tired to drive dilemma11:10 Why documentation matters11:50 Three key takeaways• Impairment = unsafe judgement, performance, or skill• GMC duty: stop immediately if unfit to practise• Red flags: microsleeps, near-misses, acute illness, unsafe driving• Never conceal fatigue — escalation protects you• REST SAFE = Recognise → Escalate → Switch cover → Transfer care → Sleep → Access support → Form plan → Enter record• Contracted practice only in emergencies if alone on site• Structured SBR handover is mandatory• Report incidents to drive system learningREST SAFE mnemonic:• R – Recognise impairment• E – Escalate early• S – Switch to competent cover• T – Transfer care safely• S – Sleep/recover• A – Access OH/Practitioner Health• F – Form a prevention plan• E – Enter a record/documentLinks:• passthemsra.com – Complete MSRA revision, notes, mocks, flashcards• freemsra.com – Free podcasts, threads and rapid-learning guides• msra.io – Smart MSRA Qbank with analytics#MSRA #SJT #MedicalRevision #UKDoctors #MedEd #FatigueManagement #GMCStandards #Professionalism #PatientSafety #passthemsra #freemsra #msraio