Bernie: The hardest Workest man in surgical show-business, yesterdayFrom our Surgical Correspondent Mr Nathaniel F Salmon FRCS
Another day, another spam email from Bernie at the Royal College of Surgeons.
"Over the last few months I have been working, through the Modernising Medical Careers Programme Board, on a proposal to secure a new scheme to enable some junior doctors, who have achieved their CCT, to acquire new skills in the treatment of rare or complex surgical conditions. There are identifiable gaps in the provision of surgical services in the NHS and I am pleased to say the DH have recognised the need and have allocated funding to support over 70 clinical fellowships for one year."
Right. So, reading between the lines, Bernie realises that MMC will churn out crap consultants. So crap, that they will need a further year of training to do the jobs that previous newly qualified consultant surgeons used to do.
"I would not support any measure which would lead to a two-tier consultant service. I am aware of the concerns of ASiT and BOTA who feel that this scheme will lead us down the sub-consultant route. I do not believe that this is the case, these fears are unfounded and I, and indeed Council, would not support a scheme which led to a two-tier system."
So, if these surgeons are not trainees, but are not yet consultants, then what are they? Oh, yeah, that's it. They're sub-consultants.
"Anything that promotes the uptake of surgical innovation within the health service has to be good for patient care. It is entirely consistent with our aims of ensuring the highest standards of care for patients."
Hang on. The RCS have supported MMC and MTAS at every stage, until it was obvious that it was a colossal fuck-up. And even then, our mate Bernie mumbled meekly that it was a jolly bad thing, and that something probably needed to be done.
And so, under his presidentship, hundreds of juniors doctors ended up having their careers utterly fucking ruined. Many of these doctors had passed the membership MRCS exam, and as members, were paying the RCS hundreds of pounds, and therefore Bernie's wages. At any point, the RCS could have withdrawn totally from MTAS/MMC, and scuppered the whole process. The resulting chaos would have still been better than the bullshit that was MTAS round 2 and then son-of-MTAS.
And following this miserable capitulation to Her Majesty's Government, he then goes to to tell us that MTAS doesn't even train doctor's properly.
Well, fuck the Royal College of Surgeons. And fuck the other Royal Colleges. Fuck MTAS. And fuck the 'sub-consultant' grade. How long will it be until every wannabe surgeon has to complete one of these fellowships? How long before the fellowships become two years? How long before there are post CCT 'Staff Fellows'?
Bernie, my old chum. You have presided over the RCS during the worst ever crisis to hit junior doctor training. And you are failing to notice the next great betrayal that HMG are unleashing. When the junior doctors of ASiT and BOTA tell you that the whole tits-up situation is about to go even more tits-up, well, maybe they might have a point. After all, it is their careers that are threatened.
So, Bernie, what are you going to do?
Dr Rant
Dr Cardigan
Dr Blue
Dr Brown
Rev Dr Green
Dr Mustard
Mr Orange
Dr Pink
Dr Purple
Mr Salmon
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Mr Beige
Ms Scarlet
Dr Informed
10 comments:
Brilliant, absolutely brilliant - and spot on
Interestingly that's pretty much what the BMA/Junior Doctors Committee has to say on the matter.
Although they've been more diplomatic... but it's all a matter of what style you prefer, I suppose. :-)
http://www.bma.org.uk/ap.nsf/Content/postcctfellowships
Keep up the good work, Dr R.
Another angry gasman
Quite possible the worst part of this (from my point of view as a medical reg) is that Bernie's been far more rigorous than any leaders from my college.
What a depressing thought.
Having said that I do think there's going to be a role for fellowships to achieve specific training roles.
I do think they should be done preCCT as OOPE. Otherwise there's no structure for assessing their quality.
Already, to become a hepatologist you need to do an extra year separate from your 5year gastro training.
I think Sub-Consultants are a very good thing & its correct with shorter hours to extend training.
Well done Bernie!
And further to my comment directly above, I think the Nazis were 'misunderstood' and they obviously had difficult childhoods.
1. You need lots more training due to the farseeing and impressive EWTD.
2. This gives you more training.
3. There will be/is an excess of Doctors.
4. The NHS as a result does not need to employ "consultants" in numbers they have done before to provide the same level of service.
So why should the taxpayer fund consultant posts when there is a cheaper option available?
They should not.
5. If you don't like it, tough, there are plenty who will do the jobs, so do us all a favour and fuck off somewhere else and whine about it there.
Let’s face it your allegiance to "training" only extends as far as your access to "snout in the trough" private practice which is what this is about.
The government have done very well in taming the medical beast, your malign influence is coming to an end and long may it continue.
Anonymous - In the interest of balance perhaps I might make one or two observations about your portrayal of docs as avaricious whingers ?
Now I suspect that you don't actually believe any of the tosh you're spouting - spend a few days on a paediatric ITU, busy GP surgery, or, dare I say A&E resuscitation room and you will get my drift.
You seem very pleased that NuLab have 'tamed the medical beast' - but do you really think the likes of Patricia Hewitt is more interested in your welfare than your average doctor ?
Don't forget since Hewitt moved on from her post as health secretary she has been hired by Boots & Cinven, (to the tune of £500,000), despite both companies providing direct competition to the NHS - before she left Hewitt busied herself paving the way for private firms to take over GP practices.
I find this incredible - surely Hewitt puts even the most unscrupulous, golf loving doctor in the shade ?
Get a grip anonymous I can accept that (some) doctors are insufferable bores when they drone on about how clever they are (especially since there is little evidence to suggest that error rates are going down) but to be fair they do handle complex life and death decisions and for this they should be adequately renummerated, as a bare minimum.
Doctors are being shat on at the moment, anonymous, what are they supposed to do, just shut up and take it ?
"I can accept that (some) doctors are insufferable bores when they drone on about how clever they are (especially since there is little evidence to suggest that error rates are going down)"
Don't mean to be an insufferable bore but what does the error rate have to do with how clever we are?
If you have to deal with hundreds of new drugs coming out over the next few years and error rates go up does that make you less clever? Or if more patients are seen by non-medical practitioners? or if you learn new techniques to try on patients, cause more errors but make the majority of them better - does that have any bearing on cleverness?
Just to make the point again, error rates have nothing to do with how clever you are.
Is 'intelligence' not a variable when (certain) diagnostic errors are made ?
But I take your point hawkeye, perhaps carelessness and inexperience are more important contributory factors (in statistical terms).
Of course, poor communication is a recurring theme linked to medical (and nursing) cock ups, and to my mind emotional and intellectual skills can play an important role in reducing risk.
Well said Dr Rant,
As a recipient of Sir Bernie's spams I am increasingly at lost as to what this man is all about. During the MTAS fiasco he stropped, threw tantrum but the the sum of all his efforts but is a effective as staccato farts at the HMG's MMC trumpet (dis)concertos.
As for the tick-box arse wipes forms that form the basis of training these days - not the number of operations performed or the length and breath of experience in own and related specialties - they do not reflect the qualities of doctors the average Labour voter would like.
Already I have to put up with ST1 and ST2 in Accident and Emergency who cannot reduce ankles or shoulders and get spooked by paronychia. Or FY2s in orthopaedic surgery who panicked at the completely normal post total hip replacement X-rays because they were never formally taught how to look at them -ie no ticked-box arse-wipes to say that they are capable.
However, these doctors will get very fast up the so-called training ladder. Dumbing down of medical training? Yes, presided over by Bernie and Co.
As for the anon who sang praises for the EWTD - you are as in the dark as Bernie's rectal content. The next time you wanted your shoulder/hip/elbow relocated or your wound sutured you have to wait for someone like me - an orthopod culled out of 'training' by MMC but who can actually do the job, with logbooks, exams, courses and CV to prove it. But you will be paffed about by ST1s and ST2s who have very little idea what to do. Perhaps the A&E charge nurse can come to your rescue.
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