The butterfly is a flying flower, The flower a tethered butterfly

Sunday, 16 December 2007

Aspiring to excellence

"may each day bring you bright, happy hours that stay with you all the year long."

I think I have become addicted to the last HSC meeting; the more I watch it, the more I understand things that I once found puzzling. Of course, this particular meeting was like an open book; you skim the surface first but the more you concentrate, the more it gives you! .. And the more I watch it, the more I have respect for Sir Tooke, both; the professional and the man. I have come to admire this man because he is truthful, honest, courageous and because he really wants what is best for the juniors and for the profession. I very much believe he will be the knight in shinning armour who will slay 'the dragon' and his MMC and rescue all those affected because of this sorry mess.

Apart from the urgent issue of redefining the role of a doctor, uncoupling F1 from F2 the way he recommends is not a bad idea, although, I wonder why not just integrate the F1 year into core training and move the competitive point to the end of this core training? At least this way British graduates can be protected from outside competition and you'd still have one competitive point. Thus, all British graduates would, at least, secure the right to registration and training thereafter, be prepared for either the higher part to specialist level in the specialty they choose or change to another? Or even be better prepared for a proper role in a better defined service post, if this is what they choose and prefer to do, or, indeed, if still not prepared enough to enter higher training and wish to compete again at a later stage?

So, I think core training followed by competitive entry into specialist training is good despite what those who prefer run through may say. Those want run through because they want one entry and one exit as a finished product; no more competing. However, core training is an open door, you enter but you can also exit; if you do not like the specialty or want to do some research then return .. etc. There is also the opportunity to say, take a year or more out for more academic qualifications, etc, and providing the system allows you to come in again, then surely, it is better than 'galloping through' training in a straight jacket.

One of the problems facing many 2007 doctors is like this left by a junior on Remedy's today. He says that he got an ST1 post far away from home, his family and friends but now feels lonely and isolated and wants to apply for GP this year but he was advised (By whom?) that he must resign first before he can apply in 2008. I know more doctors trapped in this same situation; accepted unsuitable posts out of fear for their career. They accepted posts either far away or in a specialty they would have never considered but for MMC and MTAS! Of course there are also those who have wives and children but had to leave and live far away because of the job, not forgetting the others who fled the country in search of the opportunity they should have found here at 'home.' Uncoupling core training from the more senior level would, I think, solve this problem but one has to still bear in mind that uncoupling may not guarantee this outcome because the number of posts remain very low. That said, I wonder if Sir Tooke will address the problems of those trapped in 2007 in his final report? I sincerely hope he does.

Sir Tooke also said that he was asked to be on the board implementing his recommendations but he refused :-( and prefers to 'monitor' from far away and act as an adviser when needed. I hope he will change his mind and be in charge of the implementation himself just in case things get 'lost in the post' ... happens a lot these days ;-)

If Sir Tooke himself takes the driving seat, I very much trust that British Medicine's 'life in his hands' .. will be safe

Let's hope for a clear and bright future ...

It's the festive season so, from one eternal optimist to another, this is for you Sir Tooke with my very best wishes .... :-)

I hope the 'rain' disappears so that this song can come true ... ;-)

“Star Light, Star Bright First star I see tonight. I wish I may, I wish I might Have the wish I wish tonight.” ;-)


fiona said...

You describe the problem faced by one doctor, who took an ST1 post far away from home, family and friends and now feels isolated and trapped. We have much anecdotal evidence but it would be interesting to know the true scale of this, as a measure of how disastrous 2007 was for our junior doctors. An audit of the outcome of MTAS is required to answer:
1. How many doctors took jobs out of fear for their careers and now want to move location/speciality.
2. How many doctors went abroad and are unlikely to return, either because they have found better prospects or because there are no longer opportunities here (I see on the Remedy forum that doctors are waking up to the fact that there is not a level playing field for ST3 in 2008, due to run-through in 2007!).
3. How many doctors left the profession and are unlikely to return, for the same reasons as in 2 above.

I suspect we may never know the answers to these questions. I think the GMC or the Deaneries are best placed to carry out such a survey and no doubt they have other priorities.

Sam said...

Hi Fiona,

Apart from those who left the country for opportunity in Australia .. etc, I imagine that a large proportion of especially the round 2 applicants accepted unsuitable posts out of panic. I suppose this will be repeated in 2008 and the foreseeable future so long as the number of training posts remain that low. I agree with you that some kind of audit/research should be done to find out how many doctors are in such traps and also hope Sir Tooke's report will do something for them.