Thursday, February 16, 2006

Modernising Medical Careers: A Guide For Current Senior House Officers

here is a circular i received today:

dear doctor

good evening, hello and welcome to your guide to MMC!

now you may have heard a lot about this radical new restructuring of junior doctor training and this letter is to make sure you are fully clued up.

imagine you are a patient! you know... those annoying people who come into the hospital and get in the way of all your paperwork. anyway as you are well aware they perpetually drone on about wanting to see a consultant ie the "specialist" in whatever area they think they have a problem. you are also aware it takes a long long time to become one. that is because being the top of your field doesn't happen overnight does it!? as we write you are probably struggling through postgraduate exams, battling through a difficult rotation in the hope that you can then get onto your 5 year registrar programme and also maybe do a PhD to boot! how long is that going to take? you poor thing, i'd say about another 10 years! A DECADE! Before you're a consultant! Admittedly you'll be really great but a DECADE!

who wants to wait that long? certainly not the patients. so this is where MMC steps in. imagine this. what if we said to you we'd cut out 5 years of your training and took away the need for any research/exams? what if we also said to you that after this truncated training programme we called you junior consultants? you could tell all your non-medical friends (there must be one) that you were a consultant! wouldn't that be cool! and here's the clever bit... we could also tell the public that you were a consultant too! then they would be happy and so would our health secretary and uncle tony too! they'd be really please because Labour pledged to deliver more consultant led services and we would have delivered more consultants in a shorter amount of time! we would satisfy our masters and the public in one fell swoop. they would never know the difference between a junior consultant and a consultant (several years experience) much like no-one know the difference between labour and conservative these days. it'd be our little secret!

of course some people say that if you cut down training then the doctors produced at the end are substandard. Poo poo we say! in MMC you will have to tick boxes on forms every few months to say how well you can communicate with people. because after all, the public are happy if they get a nice friendly doctor to chat to. you don't actually have to make the right diagnosis or treat a problem correctly. we have data to prove this. the breakdown is 5% what you do, 20% how you look and 75% how you say it.

and where exactly do you fit in? there's an incy wincy problem here. we know that there are for the first time in decades plenty out of you out of work currently because woops! we expanded the number of medical school places but not the number of jobs. woops again! MMC really only applies to doctors who graduated last year. so you guys two to four years out of medical school don't really fit in to our plans. but you have a few options (there are always options. smile!):

1. get a registrar position by Aug 2007. that way you can do the old training programme and become a consultant the old way and probably be really good! it's not very modern though. and any of you who thought about taking a break to travel or do something else better not. time's running out for you lot. sorry for ruining any plans you might have had and not telling you this years ago.

2. wait till Aug 2007 and start MMC from scratch. you will of course have to work with doctors 6 years your junior and you will be hopelessly overqualified. but it's new and trendy! plus you will get to do blocks of placements like you did as a student in completely unrelated specialties! that won't help you if you really want to be, say, a gastroenterologist. you might frown and say it would be a waste of time but it'd be fun!

3. stay in your current position forever!!!!!!! the problem with MMC is that the new doctors, by virtue of their reduced training won't be able to do anything and will have to rely on you old school people to, for example, run the hospital at night. so we're hoping a few of you will stay on just to do that. if not we can always get doctors from overseas to do this job because frankly we wouldn't like our homegrown boys to take up slave labour positions with no career prospects.

there you go. please don't worry that you might become part of a lost tribe of doctors (though that too is cool! you'll be like Dr Littlest Hobo - going from place to place in search of work) - as we say on our website:

"In 2007, when the new specialty training will begin, there will be measures in place to ensure the doctors in the current training system are not disadvantaged. "

the funny thing is we haven't planned any of that yet and may not get the time to because of being so busy with the new graduates.

anyways! hope this helps.

all our love

the MMC team

our website

[i am listening to Beth Orton's new album, comfort of strangers]


Kate said...


Anonymous said...

It's as if they can't forward plan at all. They buggered up the Education system by keep pick, picking away at it, changing the system from day to day, so that no-one could plan for their future - now they're doing it to the Health Service, but on a far larger scale, I think. I really believe that they're trying to improve things, but they're just making it so much worse!
God help us all.

Dazed & Confused said...

yeah i agree. the plans are just so short termist, completely in line with timings of general elections. yes they are attempts to meet social and economic demands but lack any foresight. the government is so caught up in appearances, buzz words and targets they just do not realise that it's a segregating system which is ultimately going to be dangerous, maybe not in large hospitals where, at the end of it all, there will be more doctors working at those twilight hours when things go wrong, but in the district generals where only a skeleton crew are on at night and have to be flexible enough to deal with multiple problems. coupled with the fact that the whole point of the Hospital At Night regime is that hospitals should run on as few staff as possible with an appropriate experience and skill mix (see NHSBlogdoc for more about HAN) i do feel concerned about patient safety, not just career progression/structure/etc

Mike said...

hilarious post! so true in a way its just rebranding. Like Mcdonald's calling regular fries "large" and getting rid of small.

would you consider putting a link to my site? Its not a blog but i feel its very relevant to training doctors, where you can read reviews of SHO or foundation year posts written by other doctors.

Sorry, there was no other way to contact you.