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19 comments:
Don't worry it will be better next year as they are changing the post grad system again.
i only found out last night at the careers meeting.
Also nice to know that people with the lowest adademic scores at medical school came out trumps with teh form.
I guess the points for 6 questions such as "give an exmaple of when you showed professionalism" should be worth a lot more than my previous 4 year Bsc...and more than a Phd...oh and more than my total of every mark i ever got at medical school.
Ah well...at least i have a job for 2 years...i just don't know which one. But at least i will skip the "new C1 " yearand go straight in as "C2".
I feel sorry for those graduating next year. They have a total of 4 months after medical school to decide which field they want to specialise in forever. 2008 graduates get a lengthy 18 months.
have the govt pulled the funding for post grad courses like they have for every other profession? or has medicine avoided that little flick of the wrist
Come on Rant team that article is from last summer, we all know medical education is fucked.
Now the Tooke report is interesting, he proposes the introduction of a new body to oversee post-grad medical education the 'NHS Medical Education England' now I was wondering exactly what his plans for Scotland, Wales and N.Ireland are?
I assume my career is totally fucked before it's even started.
Did you read the article in the BMJ? The CMO has convinced the Secretary of state for health that run through is the way. It is now expected the the HSC report will reflect this. They will also ask Darzi to look at medical education while looking at the overall picture of the NHS!
Your opinion Dr Rant?
Asking Darzi to look at anything (bar the odd gallstone) is a kiss of death.
His sole purpose in this entire "caper" is to afford NuLab policies with a glare of pseudo-medical spin, perhaps like Alistair Campbell in scrubs.
To "anonymous", who perhaps suggests medics suckle from a golden teat by having our training "paid for".
Firstly, we provide a service to the NHS - an important one, and a bloody good one for which we are well trained.
Study leave budgets for juniors are frankly fucking risible, with all professional exam fees coming from juniors' own pockets. These being core components of our basic and higher specialist training, and very necessary for the running of a high quality NHS.
Secondly, if you would like to suggest another organisation in which I can obtain sufficient training for a CCT, perhaps you would like to indulge me. Unlike comparable professions (law, accounting, banking, dentistry etc, which you possibly allude to), we have no power to shop around for the best positions.
Thirdly, just fuck off.
At the moment that seems to be linking to an old article about Max and Emma (who look really strange in that photo btw) - I presume you were talking about a newer article? Is the link wrong?
no was genuine in my wondering whether medicine has had the funding pulled for postgrad courses like other postgrad courses in other subjects recently announced?
Yes... the whole grand tombola is starting again! This time with more trees being sacrificed as on-line recruitment have gone areola up.
More demands for form filling and interview courses. More running about the country to get tick-box arse wipes (mini-CEX, DOPS etc) signed.
I would rather catch up on my journals and papers.
At the same time the dumbing down of medical training is taking its toll. Never have I thought that as an ortho middle grade I have to incise and drain paronychia in A&E (referred by A&E as 'septic joint'), or having to attend to a dislocated total hip replacement in theatre the next day as the A&E no longer allows patients to be sedated. Or having to re-clerk patients as FY2 only have to fill in a bog standard admission form that has a two inch gap for neurological examination even when presented with patient with back pain plus leg symptoms. Forget about getting an FY2 to consent for carpal tunnel decompression as he/she has never seen one.
However, these are the candidates for the run-through training. The ones with experience and perseverance are culled out of the system that care very little for the patients they claim to protect or doctors they claim to guide.
Hmmn... it's interesting.
Of course, the F2 grade is a very heterogeneous bunch of guys, containing a great number of doctors who are never destined for surgical careers. After house jobs, the pathologists, microbiologists, even physicians of this world would have gone straight into their specialist training and left the surgical bulk to those most suited to it - er, the surgeons.
It surprises me not one iota that, as a group, F2s are less good in surgical posts that the old surgical SHOs training for MRCS/old FRCS. Why would you give a shit about decent service provision if you were unsuited to the job, but were forced into it to fulfill spurious educational requirements.
Does that make any sense to anyone else?
@ anonymous re: funding
Doctors have never had postgraduate courses paid for. We have had a study budget to contribute towards some courses. It used to be a reasonable amount of money but the cost of courses has gone up and the study budgets have gone down.
We are expected to go on at least one educational course annually, keep things like ALS (Adult Life support) up to date, attend national conferences, and do our postgraduate exams. The study budget cannot be used towards exam fees. Each educational course costs about 700-800 quid. ALS is 400 quid (not including transport/accomm). National conferences are about 100 quid/day. Postgraduate exams (which come in parts eg part 1, part 2 and part 3) cost 400 quid each, each attempt. Any other things you want to do to further your skills (eg a certificate of education, or a surgical skills course should you be a slicer and dicer) are more money.
Annual study leave budget? £700, if you can even talk your hospital into paying it out. And it is always a pay first, be reimbursed much later situation.
So no, our "funding" hasn't been pulled - it remains as pisspoor as always.
to drchris
You said:
Why would you give a shit about decent service provision if you were unsuited to the job, but were forced into it to fulfill spurious educational requirements.
Does that make any sense to anyone else?
Make a lot of sense to me. All the FY1s and FY2 in my ortho job want to be GPs; therefore, why bother with pr for prostate (urinary retention plus blood in urine) or learning about consenting for TKR (total knee replacement). After all, at this stage in their secure run through training the aim is to tick boxes instead of going for learning experiences which are not yet quantified. As for A&E the target is to get patients out of the department, which must frustrate some A&E doctors who want to treat patients. (I should know I did A&E when NuLab started chanting the four hour mantra)
Ivy Bolas - if A&E doctors want to treat patients then why do they refer paronychia's to ortho [assuming there are no complications such as spreading cellulitis, etc] - you can't blame that one on the 4hr target since it takes 10 minutes to perform an I&D [if you include dressing and clearing up the mess].
By the way I have never heard of A&E refusing to reduce dislocations.
Of course A&E staff try and fail sometimes [to get a joint back into place], but leaving somebody in agony overnight simply due to the fear of sedation is a new one to me, it is unethical and of course delay only increases the risk of a neurovascular injury.
so
http://news.bbc.co.uk/1/hi/education/7178836.stm
applies to medical post grad training too? and students will have to fund the full course cost themselves same as foreign (non EC) students rather than the discounted fees at present?
or is medicine excempt?
Medicine is not a postgraduate degree in the UK.
Some people do do other degrees first, but the majority of medical students in the UK went to medical school without obtaining another degree first.
It isn't about postgraduate work, it's about funding for a second undergraduate degree.
yea i know all that, but dont some medics do some postgrad courses after they have qualified?
this article is pertaining to the current careers of my brother and sister in law. it may be from a couple of months ago, but i think its still relevant, its this year that they're affected. i was a bit slow to send it in to the rant team.
Nick Hodges
To A&E charge nurse,
Nope, the paronychiae were all straight forward. One patient was almost sent home with more antibiotics. As for reductions of dislocations, that A&E only allows one attempt in A&E (to be decided by the nurse in charge) and under morphine and entonox only. There is a senior A&E nurse who can and does these procedures. It is the FY1s and FY2s who who cannot recognise a paronychia or talar shifts that I worry about.
Anyway, medical education ie training on the job is so dumbed down that patients suffer. Gone are the days when the A&E consultants can leave the department to their SHOs who would have done a whole year of acute medicine and surgery.
The foundation years, although two years long, include spells in biochemistry, neonates, psychiatry -each lasting not more than four months. So, the doctor patients see in A&E may be one who has never done an acute speciality before. (I know you know all these)
Perhaps the powers that be will look into the experience and skill of a doctor when considering appointments. At present, jobs are ring-fenced for the newbies.
Perhaps hospital league tables should include the ratio of experienced (ie not in training post) doctors and nurses to fresh run-through medical training doctors in A&E departments to give patients more 'choice' as to where they can have effective treatment.
Ivy Bolas (what a hilarious name, love it),
I completely agree with your sentiments, but urge you to exercise a might of caution over how they are expressed. It is not the fault of the juniors if they lack the experience of trainees past. It is not the fault of undergraduate medical training, which in reality is as it has always been.
Rather your ire should be aimed at the spacktards who messed around with the postgraduate educational system in the first place. And handing out the learning opportunities to noctors is unlikely to help very much, is it?
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