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

Monday, 30 July 2007

The biggest job swap in the history of medicine!

Does the 30,000 junior doctor job swap on 1st August 2007 make the Guinness book of records? I am sure the unprecedented event does and I will try to see if I can find an address and email the Guinness book of records to include the event in their records as I truly think this is probably one of the biggest cockups in the history of man. It will never be forgotten! This is an event that will definately make history and will be taught in years and years to come by experts in fields far apart in medicine, management, economics and politics, etc. It will become a prime example of mismanagement and bad politics for generations to learn from and avoid, of course, by then, it would've also become a big laugh and a great example of foolishness!

Even the Sun is reporting the Mayhem that may take place on August 1st. Will patient care suffer the results of the biggest medical debacle in history? We shall have to count down the hours to August 1st and just wait and see! I sincerely hope no patient will die or suffer harm because of this fiasco and especially those who may suffer injuries because of unpredicted traffic accidents, heart attacks and the like. Since the start of MTAS everything beyond the wildest of the imagination of anybody and everybody has gone wrong! I sometime feel that had all the anarchists in the world been locked up together in a secure mental institution for a looooooong time to think of ways to cause the biggest of mess, they would never have been able to come up with a mess near or remotely close to that of MTAS! Grandiose, magnanimous; call it what you like, words are not enough to describe the scale of the foul up! .. and the saga continues! There seems to be no end on the horizon either! What else can possibly happen again?! No prizes for suggestions because I am sure no one can ever win over the MTAS circus!

But, hospital consultants are trying their best to do all they can to avoid problems on the day. New FY1s induction started today but I have no idea if it was only my daughter and her friends or if it was policy for all FY1s. Her first job will be in Care of the Elderly or geriatric medicine. She met her consultant and the registrar today and thought they were both very nice and feels this will be a good rotation especially that she also likes old people. The consultant told the FY1s who will be under his supervision that he and the registrar will do the clinics on August 1st while the four FY1s take care of the ward one their own. Seeing they looked a "little" puzzled, well, it is their first day as doctors! He told them they'd be alright and that he would of course be easily contactable in case they needed help :-) I suppose similar solutions will be implemented up and down the country on August 1st.

A few years ago I bought a piece of drift wood in Bournemouth incribed with this:

"No one can bomb this place and end the confusion!"

I never thought it will apply to a real situation but it does now!

Is "cock up" a rude word?

Homeless junior doctors!

I've just learnt from an ST doctor that he only found out which hospital he would be working at yesterday. It is nearly 4 hours drive away from where they live at the moment. He needs to be at the hospital 8am on Wednesday 1st August. Today this hospital called and is unable to confirm accommodation for him for 1st August. He tried two hotels nearby but none have availability for first August! His father suggested that he can borrow the family car, a people's carrier, remove the back 5 seats and use the space to sleep! :-)

He has no idea how much he will be earning and did not receive any employment contract to date!

I wonder how many other junior doctors are in the same predicament out there!

British Medicine, preserve the tradition

Agenda for change Has "rewrote the job descriptions of more than a million nurses and other staff, increased the wage bill to £30bn a year without benefiting patients"

So, giving junior doctors' traditional duties to other "health professionals" doesn't work?! And, is working out to be lots more expensive than employing doctors to do the work properly and without delay?! But, we all knew that IT WILL NOT WORK! It's common sense; it is more efficient to have a clearly defined role in whatever you do then be asked to do it to the best of your ability!

.. I know a doctor who works alongside a "nurse practitioner" in a hospital nearby. She told me that the nurse practitioner sits every morning at her desk and attends to the day's pile of forms in front of her; this I can't do, not trained to do this, and this, or this, ....... So the work goes back to where it belongs; to the junior doctors of the department, while she gets paid for .... !

Nurses are trained to nurse! And are excellent when they are left to do what they do best, nurse patients back to good health! This "blurring" of roles only leads to errors and faults being totally lost in the system, no definition of who is responsible and accountable, costs a lot more than defined professional roles and, above all, greatly harms patients.

Revert back to traditional medicine, this steeped in history and tradition profession already has the reputation for being

"The best in the world!"

No to the blurry "modernisation!" Preserve the golden standards of British Medicine

"If it ain't broke, don't fix it"

Saturday, 28 July 2007

Declaration of a new doctor

Today, I attended the affirmation ceramony of my daughter and all her year group where around 300 newly qualified doctors "promised" :

"Now, as a new doctor, I solemnly promise that I will to the best of my ability serve humanity—caring for the sick, promoting good health, and alleviating pain and suffering.

I recognise that the practice of medicine is a privilege with which comes considerable responsibility and I will not abuse my position.

I will practise medicine with integrity, humility, honesty, and compassion—working with my fellow doctors and other colleagues to meet the needs of my patients.

I shall never intentionally do or administer anything to the overall harm of my patients.

I will not permit considerations of gender, race, religion, political affiliation, sexual orientation, nationality, or social standing to influence my duty of care.

I will oppose policies in breach of human rights and will not participate in them. I will strive to change laws that are contrary to my profession's ethics and will work towards a fairer distribution of health resources.

I will assist my patients to make informed decisions that coincide with their own values and beliefs and will uphold patient confidentiality.

I will recognise the limits of my knowledge and seek to maintain and increase my understanding and skills throughout my professional life. I will acknowledge and try to remedy my own mistakes and honestly assess and respond to those of others.

I will seek to promote the advancement of medical knowledge through teaching and research.

I make this declaration solemnly, freely, and upon my honour."

A big promise which can only be kept by doctors and no other professionals. It is such a big promise to make and to keep unless you have passion for medicine and the true desire to help people. Only doctors have the ability and know how, the resiliance, natural compassion, have the dedication and commitment and above all, no one can keep such promise unless they have the highest level of integrity. Only doctors can manage and keep such promise regardless of the difficulties they may face on the way.

This is why doctors do not strike when faced with injustice while others do.

This is why Medicine must always be protected, cherished, nourished and held on high ground for the benefit of all of us, for humanity.

May all those new doctors who made this promise today be able to fulfil their promise, be appreciated always and prosper along the way.

Patients pay the ultimate price for NHS errors

Well, obviously! A logical conclusion that does not need a genius to figure out but I thought the NHS is having its "Best year ever!"

Thousands of patients are feared to be dying needlessly every year because of poor communication between hospital staff, faulty equipment and a lack of skills.

An analysis of errors has found that some staff failed to make basic checks and that others did not see that their patient’s condition was quickly deteriorating, with fatal results.

If you give doctors' work to nurses and other health workers who do not have the depth of knowledge doctors were trained to have, then what do you expect?! And now doctors' training budget has been dramatically cut and thanks to MMC, doctors training hours will also be slashed, by three quarters in some specialties and by at least a half in the rest, then expect to see the trend rising to catastrophic proportions! More and more patients will die because of errors in judgement, lack of experience and expertise! The "big bang" will be upon us soon when nearly 14,000 doctors are made unemployed and more and more of their valuable expertise is lost, of course ultimately, patients will suffer, en mass!

That is what doctors have been saying all along! But, no one seems to want to listen!

All this talk about "cuts" and "rationing", I had no idea Britain was that poor! Since she is not, where does all the money go?!

Friday, 27 July 2007

Latest MMC guidance

From MMC guidance dated 27/07/2007:

Applicants are eligible to apply for the 1,000 additional posts only if they have been interviewed in Round 2 of the recruitment process and would have been appointed had there been a post available. These applicants will have been placed on a reserve list after the specialty that they applied for was filled.

What if a doctor applied everywhere in round 2 but did not get invited to an interview?!

The London Deanery's deadline for submitting an application in all levels and all specialities is noon on Monday 30 July 2007, only 2 days from now!!! If a doctor misses this deadline, then he missed out on the extra jobs available at the end of round 2!

How much more can junior doctors endure?!

Some are already breaking; an excellent junior FY2 surgeon friend of my son has now decided not to apply anymore in round two. He has given up! What a waste of an excellent young doctor who was always praised by his seniors for his way above average abilities and genuine commitment to medicine and his patients.

No time for security checks!

The Telegraph 27/7/2007

"Hundreds of junior doctors, including overseas staff, will be employed by hospitals from next week without undergoing proper security checks, it was disclosed last night.

Hospital trusts have been unable to investigate the criminal records of trainees because they have received their names only in the past two weeks - and checks take at least 28 days."

No time for security checks! Repoted in The Times on line here too! Well, it's not the junior doctors fault! This is just another cockup to add to the very long list of the MTAS debacle! It should be the responsibility of doctors to hold a valid and up to date CRB clearance to be renewed on yearly basis. This would have avoided such problems and employers having to make a new enquiry whenever doctors move between jobs!

Is there an end to this humiliation?!

This below is a copy of an e-mail sent by one of the many NHS trusts offering FY1 jobs to senior SHOs, much more senior than FY1 doctors. The doctors' earnings will suffer accordingly of course! These jobs are for three months from 1 August 2007 and last until 31 October 2007, the end date for round 2 applications and the last opportunity for juniors to secure a post this year. It is unclear how many doctors exactly will participate in that scheme initiated by Patricia Hewitt, the former Health Secretary or how many will become unemployed by the end of round two but it is estimated that 16,000 doctors are chasing approx 2,500 remaining jobs in round 2, here is the e-mail:

"Dear Doctors,

In line with NHS Guidance, Doctors who are eligible to apply for Round 2 of MTAS and hold a substantive training post as at 31 July, 2007 will be offered an employment opportunity until the end of Round 2 on 31 October, 2007.

An employment opportunity covers a range of options from clinical to non-clinical work. This opportunity is not a training opportunity and does not guarantee a specific salary or grade. The salary will be related to the job on offer. It does not guarantee full-time work and does not automatically include out of hours work supplements.

If a doctor is made an offer of employment and chooses to decline the offer, the Trust and the SHA is under no obligation to make a further offer.

Medical HR is working to establish numbers of Doctors eligible and appropriate vacancies available (the vacancies may be at both FY1 and ST level), however, as you can appreciate this is an on-going process with Doctors still being involved with interviews, and having to wait for Deanery approval to recruit into training vacancies that they are not able to fill and the number of new Doctors appionted who may not be cleared to work on the 1 August. It is essential therefore that you inform us if you have accepted an offer of a post from 1 August, 2007 and will therefore be leaving the Trust 31 July, 2007.

I would be grateful if you could confirm:

Receipt of this email

You are still without a post from 1 August, 2007.

If you have any queries, please ring me (Ext 2207) or pop into the department.


This is no way to treat high calibre professionals such as doctors! Is this a delibrate attempt to scare jobless doctors off so that they do not take up the offer on those three months guanteed employment?

Score your own application form

The London Deanery is now advertising it's remaining round 2 posts for junior doctors in all specialities and all levels and the deadline for submitting applications is 12 noon on 30 July 2007. In all downloadable application forms, it is probably the only deanery to include a score sheet at the bottom of the file. It even tells you the minimum score needed for shortlisting. Very useful for scoring one's own application form and making sure an applicant has included everything about themselves that satisfies the required criteria either when applying to The London Deanery or elsewhere as this score sheet must be uniform. Very nice of the London deanery, other deaneries should follow suit IMO.

Wednesday, 25 July 2007

MTAS did a lot more harm than anyone thinks!

My daughter had a party at home last week to celebrate finally becoming a doctor. So happy, she printed cards with her new status and invited what must have been 50 friends from school, college, neighbours, the lot.

Two of her childhood friends are now "health professionals" and of course graduated 3 years before her. They were all talking about money and how they now made the same as my daughter and lots more because they started earning three years ago, At one point, one of them, a radiographer, said that she teaches new doctors how to do things "all the time" in the hospital and that she found it "shocking" that they know nothing at all when they first start working! My daughter just smiled but I did not like it and said that of course, as a radiographer, she knows more about radiography than a new doctor because this was her domain but that the doctor have a much bigger pool of knowledge about medicine in general. Saying this, I then made it a point to say that doctors do benefit from those around them who do other related jobs such as radiography and nursing, etc. I could tell she didn't like what I said at all.

The other friend, a podiatrist, noticing the look in her radiographer friend's eye, quickly said that she too finds it shocking that she has to teach doctors to do the simplest of things, like dressing wounds, that what she finds "Really" shocking was how "thick" some doctors are, new and old! but then noticed that I wasn't happy with the remark so she smiled and quickly added that she is sure my daughter was not one of those thick ones, she's always been soooo bright! I smiled too but had to say that doctors work hard all their life and the knowledge they acquire in those six tough years of study never go to waste but that knowledge returns naturally when they settle into their new positions. I then changed the subject. I could see the two "friends" did not like what I said and would have continued this line had they not been at our house for my daughter's graduation party. Later, one of them made a passing comment that there was no longer any difference between a doctor and a nurse, since nurses now can do postgraduate studies up to PhD level and earn nearly the same money as doctors if not a lot more!

What I found surprising was that all medics, including my sons, said absolutely nothing. After the party I asked why didn't they comment? They said that they hear this sort of talk from other health workers every day in the hospital! So what do you do to stop them? Nothing, change the subject like you did at the end mum; if this type of talk makes them happy, let them.

My other son, a third year medic, said that at his hospital, doctors in A&E for example, used to wear green scrubs while nurses wore blue but a few months ago the hospital changed this and now everybody wears the light green scrubs and only the consultants wear the dark green ones. How will patients know who is a nurse and who is a doctor?! Oh, you look hard on the pocket, if you can spot the badge because some nurses now also carry "their" stethoscope in their pockets and this can cover the badge! Sometimes you have to ask them if they are a doctor or a nurse when you need to have a form signed by a doctor!

Doctors and medical students both told me that they always experienced some bullying by other "team" members but that this has dramatically increased now because of the humiliation and disrespect doctors suffered since the start of the MTAS debacle!

This is not right.

Tuesday, 24 July 2007

Patient centered, clinically led and locally accountable

In a letter to all NHS staff, Professor Sir Ara Darzi , the new health minster says that
Any objective assessment shows that the NHS is performing better than ever

But he then announces yet another review of the NHS and a once in a generation opportunity to ensure that a properly resourced NHS is "patient centered, clinically led and locally accountable" ... Whatever that means!

To ensure this, he is inviting participation because "Your views matter" and has provided this e-mail address for this purpose:

Of course our views matter! :-)

Monday, 23 July 2007


NHS bosses are to get £1 million redundancy payout! While doctors training budget has been cut so that the NHS can balance it's books . Thousands of much needed doctors with up to date experience and qualifications are facing unemployment in just one week's time without one penny redundancy pay! The majority have families and mortgages.

"A true hypocrite is the one who ceases to perceive his deception, the one who lies with sincerity"

BOTA has decided to fight

I like Dr Grumble, he sometimes reaches information other medics cannot reach, Or let's say he does it sooner than most anyway :-) Apparently, the British Orthopaedic Trainees Association has made a submission to The Tooke review for the resignation of Sir Liam, Lord Hunt, Professor Elisabeth Paice and Professor Carole Black. They also do not seem to have much trust in The PMETB and do not at all find it fit for purpose in it's current form.

Good on them but, this makes me wonder, why don't all the medical royal colleges and associations unite for once to have a stronger voice capable of a proper fight to affect real change?!

Sunday, 22 July 2007

What is happening to British Medicine?!

This picture is from the good old days when nurses did the nursing and doctors did the healing, but more! Look at this! Scroll down to read the job description too! We have enough well trained surgeons at great expence but MTAS has decided to either force many of them to leave medicine or emigrate to Australia come August, only a week from now! Why?! Why give surgeon's jobs to nurses and pay them nearly the same to do it?! Is this the future of surgery in this country?! Shorten surgeons training hours and employee nurses to do the theatre jobs juniors used to doing as part of their training! The ad says those nurses would have to pass "Royal college exams!" What RC will this be?! Of nurses or surgeons?! How will future surgeons be trained then?! Is this safe for patients?! I have seen a similar ad on NHS advertising for a Biology graduate to train as an Anaesthesia practitioner for two years and get paid around the same as a junior doctor! You also hear about all those other practitioners taking over the work of doctors in Obs&Gyne, GP, radiographers writing their own patient reports ... etc, etc Is there no protection for the profession and doctors anymore?! Where is the BMA and the Royal Colleges in all this?! When is this attack on medicine and doctors going to end?! Is there no limit to what policy makers can interfere with?! Some policy makers out there need to be put into straight jackets to protect the public from their foolishness!

The count down to The Exodus!

MMC, the brain child of the Chief Medical Officer sir Liam Donaldson came about to "build the pathway that would lead the lost tribe home", instead MMC has actually lead some of our best and most able doctors either to leave the profession they are committed to or exit this country in pursuit of their career and stay out forever! A forced "Exodus!"

During a much awaited first and only TV interview with Sir Liam Donaldson, the CMO for England on Channel 4 he said "my Principal aim was to make the SHO years more humane, more based on education giving doctors a much better career structure" A noble aim indeed but how do you do that? Surely not by shortening the years of training and forcing the SHOs of the lost tribe to compete for training jobs with the new system foundation year doctors and cut the budget for training jobs by £135,000,000 leading to a huge cut in the number of training jobs! Surely not by letting loose the untested MTAS robot to crunch applications and spit out those it deemed "Not appointable" crashing the careers and aspirations of some of the brightest, most qualified and best doctors in this country! How humane is this?!

He added: "It was a very complex programme to implement and the transition was a very big transition"
Well, if those in the know knew this beforehand, Who rushed the programme through in such a hurry?! And why?! Despite repeated warning from the medical profession?! Why was the crazed MTAS monster allowed to crunch the hopes and aspirations of some of our best and most dedicated junior doctors in the way it did?!

When Sir Liam was asked to give some figures of how many doctors will become unemployed at the end of round 2, he said, he did not know yet! What was more surprising is that he offered no solutions or any hope to those affected and will become unemployed and a very possible career termination by this saga! Many brilliant doctors are now preparing to leave medicine and round 6% of the total who applied this year; some of our brightest young doctors are now packing to leave their loved ones and leave the country with near to naught hope of returning to training in Britain! The count down to the Exodus begins!

This is the real achievement of MMC sir, The "Inhumane" Murdering of Medical Careers and the separation, heartache and breakdown of families and good people, either doctors or indeed the patients who will eventually suffer.

Saturday, 21 July 2007

Sir Liam targets "fat and binge drinkers"

The architect of MMC banned smoking in public places. Now he targets "fat binge drinkers." Has he had a look at himself in the mirror lately? He wants everybody to eventually look the same; social architecture and engineering to make us all clones of each other.

Friday, 20 July 2007

More shambles as job offers are made!

Just read on Remedy UK's forum that a deanery phoned a successful candidate and offered him a job on condition that he accepts there and then, otherwise, the deanery would phone the next doctor on the list! The doctor asked for only 24 hours to decide but they refused. The doctor told the the deanery employee that he would phone them back in a few hours but when he did, a little time latter, the deanery said the job was gone!

Another junior doctor I know received an FTSTA offer which he accepted but continued to go to interviews. At one interview, he was told by the examining panel that he got the job, brilliant, he thought and returned home to write to the first deanery to reject the FTSTA as per the rules, which he did. A few hours latter, he received another job offer by e-mail from yet another deanery which he rejected too as he preferred the one he was offered verbally. This was more than 2 weeks ago and to date he has not received an offer e-mail or anything to confirm the offer from the preferred deanery! His start date is 1st August in a far away city and no accommodation arranged!

Round and round MTAS style

Those who secured posts in round one were lucky, either they genuinely knew how to answer the "Creative" writing questions because they have a degree in English literature or at least an English A level at grade A, or they used professionals to fill them up for them for a large fee. Either way, the majority secured suitable posts, actually, over 11,000 of the roughly 14,000 proper Specialty Training posts or ST posts as the MMC calls them while the rest got some of those not very well understood FTSTAs. A large percentage of top candidates with excellent qualifications and references left round 1 with nothing as CVs were not allowed! The selection was blind! A lottery!

Now, round 2 has started and the stampede for the crumbs is hot on its heals. Job ads appear and disappear at the blink of the eye; now you see it, now you don't. Whole geographical areas advertising very few jobs you can count them on one hand! Was this what Ms Hewitt meant by "substantial" opportunities in round 2?!

Despite promises that MTAS was dead and has been abandoned for good and doctors allowed to apply anywhere they want to include a CV, some employers still don't allow a CV, most employers still use the same MTAS style creative writing questions; "Tell us of a time when you were under pressure, how did you react and what was the outcome?" But those poor young doctors have been under unprecedented pressure for the past six months! During which time they manned our hospitals and took care of their patients to an immaculate standard! The outcome? Patient safety has been maintained because of those doctor's hard work and high moral standards, total professionalism and dedication! So, how dare those employers ask such a stubid and cruel question and its like during such tough times?! When those juniors themselves are on the brink of total career termination, total waste of hardwork for years and years, families being split up when one or both partners are placed 100s of miles apart! They are on the brink of breackdown, even suicide?! MMC employers, have mercy!