see you all very soon

*sigh*

*another sigh*

but not sighs of desperation, misery and discontent

no, these are sighs of relaxation, happiness and inner peace (albeit through the obstructed sinuses, productive cough and general shitty feeling that man-flu lends itself to.)

it has been just over a month since i left work. for the first time in four years i had the whole of christmas and new year (and also weeks either side) to relax and rest myself. money hasn't been an issue because i've been doing a few locum shifts (extra last minute shifts to cover illness, etc) at my old job. perversely, locum shifts are paid much much better than if one does the same shift as a regular salaried doctor. as anti-consumerist and anti-materialistic as i am, it is amazing how double (sometimes triple?) pay will make even the most mundane tasks bearable.

and, in a week, myself and Ms D&C (who has also quit her job) will take ourselves off travelling for a few months. i can't wait.

some have told me what i'm doing is mad, career suicide, etc. fuck them i say. i've never been one to do what i've been told. at the end of the day it comes down to what makes you happy (surely?) having said that, i do have a bit of a back up plan for when i come back. looking back at the stuff i've written in this blog, if i was to be honest, i don't think i ever really could leave medicine full stop. for all the shittiness and shitty shitty times, at the end of the day i think it's what i'm good at. given the short time we each have on this planet, i've come to the decision that by being a doctor i can still make a bit of a difference. i'm not saying i'm going to cure cancer or save millions. it's not about that. as time has gone on, i've realised that (for me) it's about the little things, the small changes, the conversation here, the bit of advice there that makes the difference. ripples in a pond.

what i think the problem over the past couple of years was that i've been dying for a bit of time out, respite if you will. now that i've got it, i'm VERY VERY content.

so this is not really goodbye (as i've been melodramatically threatening in the posts preceding)... more of a "see you later." i'm going off to have some adventures, experience a different way of life away from medicine, see the pretty colours of the world.

i do think i'll be back. i'm pretty sure i'll be back. hopefully i won't be a miserable bastard when i return. at worst i'll return pissed off to be home but at least ready to start afresh.

and at best i'll be a rejuvenated person with a few exciting stories to tell.

i'd also like to thank everyone who comments/supports/encourages me to continue this blog. even if i don't reply, i do read every single response.

so long everyone. i'm not sure when i'll next post but i'll see you all very soon.

much love

[i am listening to She's A Rainbow by the Rolling Stones.]

Musings Of A Disheartened Ex-Doctor

well that's not quite true.

however i did resign today.

i'm not quite sure how i feel. come january there will be no more of this nonsense.

the future awaits.

[i am listening to Wilco]

the MOADD twilight

it's been a while since i've put fingers to keyboard on here.

i blame (in particular order):

1. general tedium with the medical blogosphere - my ranting about Modernising Medical Careers, the general shittiness of the medical profession in the UK and ennui with the lack of control of my career and life is starting to bore even me.

2. Facebook - i thought this would be a fad that would die in a few months but sadly no it is taking up a large part of my internet time.

since the last time i wrote, things have changed and i've done quite a few things.

i went to the amazing Latitude festival in Suffolk. i had a spiritual experience watching the Arcade Fire.

i went to Cornwall and ate well, surfed and lazed around.

i've been getting into the british street art scene and went to a couple of private shows in uber-passe Shoreditch. not tempted to buy anything yet.

i spent about three months not doing any on calls, sitting in outpatient clinics looking after the elderly. a very rewarding and chilled out time. i miss it.

i am also now a Member of the stupid Royal College of Physicians which means nothing to most people and in reality means nothing at all. except that i finally passed some exams and 3 grand simultaneously passed out of pocket. i have a few more letters after my name.

i have left my hospital (where i was for three years) and moved to an even bigger hospital to work in intensive care. it's ok. the doctors however are all posh toffs who don't listen to anything you say. i may as well be invisible.

i am planning to resign in January and go travelling for the rest of the year. this is career suicide as i obtained a training position for 2007-8 unlike thousands of my peers. but frankly i don't really care anymore.

i think that i shall probably delete this blog soon. it hasn't really served the purpose that i felt it would but it was fun while it lasted.

i'm dreaming of far away places. the sun is setting here.

Dr D&C is disheartened with blogging

this man is a genius

i have been far too busy to post recently. i am burning the fun candle at both ends as they say. this weekend i have been at All Tomorrow Parties and a jolly good time i had too. anyways i am now a nick cave fanatic and i urge you all to be fanatics too.

[have a guess at what i'm listening to sherlock]

i am honoured to have this man as a friend

i wrote about him a while back. long time readers of MOADD will remember that a year ago current medical students petitioned the government/DOH/MMC people regarding the stupid system they had to use to apply to their first medical jobs after graduation (have a read here - sound familiar?) i at the same time condemned the medical student leadership in this country as being a bunch of sycophantic wankers. hmm... medical student reps... wankers... doctors' leaders... ineffectual pricks... everybody... sold down river... hmm. i feel there may be a connection here.

anyway my buddy orchestrated this petition against the moronic system. it got some press. it got noticed. for his troubles he got asked to join the MMC team to represent students and help make it better. he slowly realised that he was appointed to be used as PR, to silence the protesting masses. as a result he resigned his position in MMC. here are his eloquently polite yet damning letters to the mendacious serpents:

____________________________

This is my letter of resignation, as sent to Professor Crockard 18/03/07.



Dear Alan,

I am sorry to inform you at what must be an impossibly busy time that I wish to resign from my position as medical student advisor.

When I took the position I had many reservations with the MMC systems but believed that I would be able to help students get the best deal from these changes. Seven months on, I retain these reservations and regret that I have not been able to have the impact I had imagined.

Now as then (when I presented you with a petition signed by 1300 students), I believe:
• The nature of the new application system effectively randomises medical students to jobs across the country
• The importance of academic achievement has been downgraded
• The importance of other achievements at medical school has been nullified by the nebulous nature of questions and the lack of a CV
• Two years is not long enough to decide on one’s specialty, to gain a broad enough range of experience, to become a good enough doctor: pressure is on to decide early, but the random nature of the application leaves no scope for strategising or planning ahead
• Morale at medical schools is low; they are not the aspirational, centres of excellence they should be, rather ‘centres of competence’
• This anxiety has filtered down to those students considering applying for a place at medical school

Through contact with a wide range of students over the last seven months, I know that these views are widely held. Just two nights ago, I talked to a Bristol student representing a group of 40 who echoed my above sentiments. I have, however, come to realise that continuing to transmit such views to the MMC team can have no effect as it is focused on the successful implementation of a system rather than the guiding principles and details of that system.

In my limited experience, the role of student advisor is not used, as MMC aspires, to ‘encourage dialogue with the stakeholders’. Instead the role seems to be a token attempt to suggest the involvement of students in MMC strategy; a publicity vehicle to lend validity to a system that has not, in fact, considered student opinion and insight at all.

When I was asked recently to find some students / SHOs who were happy with the new system to help build some positive press, I knew this role was not for me. I am not interested in spin or image, in making something seem other than it is. I am interested – perhaps naively - in getting the popular voice heard and acted upon and in standing by my own personal, political and professional principles. I now realise that in order to do this effectively, I need to be working within a different framework.

I would like to thank you for giving me the opportunity to fill the role and personally wish you all the very best for the future. I can honestly say that I have enjoyed meeting you and having the chance to work with you and the team as a whole.

Yours Sincerely,


Alex

This is my letter as sent to the CMO 31/03/07:



Dear Professor Sir Liam Donaldson,

I recently resigned as medical student advisor to MMC.

Despite claims from the health minister that the new Foundation Programme has ‘widely been acknowledged as a success’ there are, and always have been, huge misgivings about it at student, junior doctor and all other levels. I hoped that access to the MMC team would give me an opportunity to make these views heard. I was wrong. Although you continually tell us that you are ‘working with the profession’ you are not, at any level, listening to it. This is why I resigned: please find enclosed my letter of resignation to Professor Alan Crockard.

From a grassroots level upwards, your recruitment of those from the profession has been tokenistic at best. My role was little more than a publicity stunt. You want to be seen to be involving us but care little for the reality of what we actually have to say.
Even at the highest levels you have been seen to charge professionals with responsibility but withhold authority.

It is not my job to outline the infinite professional, personal and philosophical problems that blight your new systems – the 12,000 junior doctors who recently marched through London could do this more eloquently than I could ever hope to – but it is my job to expose the growing chasm between yourself and the profession.

Your agenda does not meet with the approval of the profession. You must acknowledge this. It is not acceptable for you to enlist members of the profession from all levels and to then ignore them. It is not acceptable to use your implementation team – MMC – as a vehicle for spin, as a way to convince the profession that things are other than they are. It is not acceptable for you to hide behind the responsibility you have dispensed to MMC and at the same time maintain your authority so you can push through your own agenda.

And yet, this is what you are doing. No matter what the profession says, no matter how vociferously it protests, no matter what damage is done to families up and down the country, this is what you will continue to do. How kind of Lord Hunt – at a time when faith in your systems is at its nadir - to illustrate the DoH’s utter contempt for the profession, by saying “I would like to reconfirm our commitment to MMC which aims to recruit and train the best doctors to provide the best possible patient care.”

This is your project. Everyone else – from MMC to MTAS, from the royal colleges to PMETB, from the advisors to the spin doctors – are merely your implementation tools. Ultimate authority rests with you. It is now time for you to take responsibility. If you continue to force through these reforms, I want you to know that it is obvious - even from a medical student level - that you are a million miles away from being the ‘bridge between the profession and the government’ that you claim: you could not be acting more undemocratically if you tried.

If you find this image unappealing, your options are clear: take heed of the groundswell against you and your agenda and cede your authority back to the profession. If this is also unpalatable to you, then you must resign.

Yours Sincerely,


Alex Liakos

_______________________________________________

what i love about the letters (apart from beautifully expressing the bigger picture of MMC) is the way they say FUCK YOU CUNT so politely. thinking about my buddy, he is actually the consumate gentlemen, even if he is from southampton.

anyways, he's far too busy with things that are bigger (or littler...) and more important than MMC at present, to which i wish him the best. i'm sure i'll see him soon and there'll be much to celebrate. it's a shame however that i am STILL keeping my pessimistic hat on: i don't think it'll make a difference to this imbecilic process. it is going to continue. at least with the march, the press coverage and letters like these, we can say that the medical profession in the UK, even if it was a bit too much too late, went down guns blazing.

see you soon dude. i've got a pint of guinness and some tea trolley treats waiting for you.

[i am listening to the new Kings of Leon song. they've shaved off their tashes. i'm distraught.]

without a paddle

MMC steering committee holds urgent meeting to modify the online application process (Prof Alan Crockard, far right)

and so the crisis goes on

this week the department of health announced that the process by which 30000 junior doctors are applying for 22000 jobs is to be urgently reviewed.

the reason for this was that several groups of consultants on interview panels refused to participate in the process on the basis that the entire selection system was moronic.

i have mixed feelings about the actions of these consultants. on the one hand i am glad they spoke out and got a review to take place. on the other hand i pose the question:

where the fuck were you guys nine months ago?

this disheartened doctor has been wingeing about MMC since last year. everybody in the medical profession knew this was going to happen and knew that the implementation was going to be a joke. we knew this from the way the newly graduated doctors had been treated by a similar system. yet the warnings were not heeded. our union, our royal colleges and our bosses sold us down the river with a group shrug of the shoulders and an indifferent "well who knows what's going to happen" whilst all along we were screaming "it's a shit idea, it's going to be shit and it'll fuck up our lives, your lives and those of our patients."

so this review: i'm not convinced. not convinced at all and sadly don't hold the views of my fellow learned bloggers (here and here for example) though i wish i did.

the first round of selections is nearly over. there is talk of the second round being modified to be "fairer."

what this actually means, and we can debate for days about what modifications should be made, is that MMC will continue, we WILL do exactly what we are told to do and we WILL BLOODY WELL LIKE IT. it is marxism at its most literal. you will be allocated and perform the task that we deem you appropriate for.

patricia hewitt and the department of health: why can you not see that our NHS is held together by the altruism of its nurses and doctors. you've already slain the nurses (below inflation pay rise this year most recently) and through MMC you've killed the morale of already demoralised doctors. the boat carrying our altruism is sinking because you've punctured so many holes in the fucking hull. time is running out patricia. how can you not see this?

HOW CAN YOU NOT SEE THIS?

there is a protest march on saturday. i shall certainly be attending. so shall many of the british medical bloggers. will it make a difference? i doubt it. optimistically it may burgeon public support. realistically the public will probably wonder what all these rich doctors are bitching about, the power-obsessed bastards. pessimistically i think 10% of the doctors who say they are going to attend will actually show up.

for we are the most ineffectual group of lobbyists ever. oh for being a bit more militant and bit less self-serving (like the new zealand junior docs who took strike action last year).

i've been eyeing up the canadian medical board exams. even if i get a job for august, what precedent does the behaviour of the DoH set for working in the NHS in years to come. i personally can't wait for the next set of "reforms" circa 2008. surely better to go somewhere or do something where you are valued as a person with skills to offer society.

i'll report back after the march. i really hope that there will be a sea of angry doctors there, like Sauron's army of orcs and that the british public will be thrusting their fists into the air and willing us to go and give the DoH hell.

but i worry that it will make no difference. i worry it's too late. i worry that come august this will all be done and the protests of the future physicians, surgeons and professors of this country on saturday will become but a whisper in the tragic history of the NHS.

[i am listening to the new Shins album]

ps. this is fucking psychedelic genius: