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

Friday, 30 May 2008

Redefine other health staff .. For patient's sake!

“The good physician treats the disease; the great physician treats the patient who has the disease”

I know that Sir Tooke recommended the re-definition of a doctor's role in his review. I have no idea how is this progressing but, as a patient on the receiving end of the services provided by doctors as well as other health staff, to me, this redefinition is internal technical stuff that I do not really understand.

However, as a patient, I have always known what a doctor does.

To me; a normal patient, a doctor is the clinical 'professional' who will diagnose and treat an illness that I may suffer from or refer me to the right specialist for treatment and follow same until I am well again.

I also know that to become a doctor, a person has to endure tough study for many, many years, pass hard exams then spend their life updating their knowledge for my benefit. My doctor is my advocate and hence, I trust in my doctors because I know my life is safe in their hands. They vowed to take care of me and have shown they worked hard to do so and I therefore, believe in them and their abilities.

So, I know what a doctor does, no need to redefine this for me.

What I have known all the time is that other health staff's role is to 'support' doctors to aid my recovery. Hence, a nurse to provide bedside care until I leave the hospital. A radiographer takes x-ray pictures of parts of my body so that my doctor can diagnose my illness. A pharmacist will dispense the medicine prescribed by my doctor/s and write the how to use instructions on my medicine/s ... etc

... But things are changing! .. And, I am truly confused! .. and very worried!

If I am unwell, do I go to my doctor or the pharmacist round the corner?! But, the pharmacist has not been trained for me to trust his judgement! And, if I ever need to be admitted to hospital, Will there be anyone nursing me back to good health? ... and, how can I find out if the medicine I am being given was prescribed by my doctors or 'others' with no training or just few days course in prescribing? Who will put me to sleep if I ever need an operation? Indeed, who is holding the knife? Who is responsible if 'things' went wrong?

This is frightening stuff! It's like putting your life in the hands of the co- users of a Double-Decker bus!

This is confusing! ... and confusing IS dangerous!

To me, if this is allowed to happen, then those who allowed it to happen have betrayed my trust .. :-(

I know what a doctor does but, I no longer kn
ow what the others do. So, Please, re-define the roles of other health care staff for me. If only for the sake of the trust patients put on you; those in charge ...

Where does 'each' role start and where does it end?

Patients have the right to know who's who and exactly what each person does ... and what solid evidence are you providing for me to trust their changing roles?

What 'guarantees' are there for me to trust 'my life' in 'their' hands?

“Apprehension, uncertainty, waiting, expectation, fear of surprise, do a patient more harm than any exertion”

Wednesday, 28 May 2008

Will polyclinics have flags?

“A safe but sometimes chilly way of recalling the past is to force open a crammed drawer. If you are searching for anything in particular you don't find it, but something falls out at the back that is often more interesting.”

I must admit that I do admire Professor Darzi. A man who, through his own hard work and dedication, worked hard and achieved a lot and is still young enough to achieve lots more and teach those who are willing to aspire to excellence like himself ... Great achievement ... I also hear that he is a nice man too.

But, I don't know about these polyclinics for London idea though. Until recently, I had mixed feelings about them .. I thought they were too impersonal, like the difference between shopping at a delicatessen where everyone knows you well enough to give you exactly what you need or a large supermarket where, although you are not being watched and are free to buy what you like, you will have to contend with 'off the shelf' quality. Of course, this is not very nice, especially when it is to do with health, we're talking about sick people, the vulnerable. The freedom of the supermarket is not suitable for the vulnerable because they are not free themselves, hence, have no choice. This is why they 'need' the personal service, not the wholesale one.

As I am not needy of care at the moment and so, have a choice, I could have been persuaded before ... until I read This Prof's article in the BMJ, in which he says:

" tighter NHS resource constraints may lead to nurse led primary care "

This sentence reminded me of the UCL medical school prospectus of around a decade ago when, at the introduction, it described how medicine was practiced in Victorian times and how the Victorians had very few doctors, the hospital used to raise the flag when a doctor was 'in the house' then keep it at half mast when he left ...

Then it dawned on me, will polyclinics have a flag too?

I haven't seen my GP for much over a year now, but he is a very good doctor. The fact that I know he is good is probably the reason why I haven't seen him for so long. I haven't been super healthy or anything as such, I just help myself when I can but knowing at the back of my mind that he is there if I ever need him.

My self help must have saved the state a bit of money too ...

You do get what you pay for except in the case of family GPs .. So I will stay with the GP I have always known, if only for a purely selfish reason this time. For, when will I ever get delicatessen service and quality at cheaper than supermarket prices again?

So, sorry Lord Darzi, .... I'll choose to pass on that one ...

"You don't really have to agree with everything a person does to still admire them"

Tuesday, 27 May 2008

Has anyone seen the juniors?!

“The higher we soar, the smaller we appear to those who cannot fly.”

I've just heard from a friend's daughter that when she went for her interview at the London Deanery, there ware only 2 other applicants waiting instead of the much larger number invited for the interview! It is rumoured that the deanery was late sending out the invitations for the interviews!

Could this be the reason for the poor attendance?

... with morale at an all time low, unfair pay, gaps in rotas and shortages of junior doctors in many places ...

Where have our junior doctors gone?!

Time to bring those who had to fly away home?

“Hold fast to your dreams, for without them life is a broken winged bird that cannot fly.”

Thursday, 22 May 2008

They've had enough!

“I am impelled, not to squeak like a grateful and apologetic mouse, but to roar like a lion out of pride in my profession.”

Yesterday, I recieved Remedy UK's script for 21 May 2008:

"Many successful candidates in the recent recruitments have found that the hospital they have been sent to was not the one that they wanted. The attitude of some seems to be that doctors should be grateful to have got any job at all - beggars cannot be choosers. These people would be shocked to discover that there were insufficient applicants in Round One to fill all the jobs.

There is no doubt that the massive interest in the run-through training on offer last year has not been matched by equivalent interest this year"

The script continues then goes on to say;

"Maybe UK grads have smelt the coffee and gone abroad. – there are now shortages of doctors in many counties.

Another possible mechanism has been the rigid compartmentalisation of entry levels. The ceilings on eligibility may have backfired, and places at ST3 have been oversubscribed while ST2 places have been underfilled. The raison d’etre for these rules and restrictions need to be seriously questioned in future.

Remedy was surprised to hear that the preferences of some candidates was disregarded and that they were placed at less popular hospitals “in the interests of patient safety”

This above says it all! ... It now seems that the tables are turning!

This debacle is no way to treat our doctors! When you ask for 'integrity' you have to offer integrity yourself!

It is the NHS employers turn now to show how grateful they are to have our sons and daughters, 'Excellence itself!' Our Junior doctors!

Forward Remedy UK -------> Always :-)

“Out of suffering comes the serious mind; out of endurance, fortitude; out of deliverance faith.”

Tuesday, 20 May 2008

Fair liaison? ... ...

"Bury the carcass of friendship: it is not worth embalming.”

MMC have now appointed Prof Bill Burr as 'Associate Medical Education Director'

"Bill is advising on the role of medical educators and leading the liaison between the MMC programme and the Department of Health’s Next Stage Review being led by Lord Darzi. This appointment is for the interim until the appointment of a Medical Education Director."

Of course, Prof Burr, despite only a few weeks ago retiring from being a doctor as well as the Dean Of Yorkshire Post graduate deanery and hence, knows exactly what it means for doctors not to have training jobs. He said, at the BMA's junior doctor conference, that he does not believe that doctors should be guaranteed jobs! and that they should be treated 'like everybody else'!

So, not a very comfortable liaison IMO

But ... Lord Darzi is himself a doctor a
nd, unlike Prof Burr, he knows exactly what it means for doctors not to have training jobs ... Let's wait for his report coming out in June .. Only next month ..

... Where do you buy patience?!

"Twaddle had a hovel, Twiddle had a palace; Twaddle said: "I'll grovel Or he'll think I bear him malice" -- A sentiment as novel As a castor on a chalice. Down upon the middle Of his legs fell Twaddle And astonished Mr. Twiddle, Who began to lift his noddle. Feed upon the fiddle- Faddle flummery, unswaddle A new-born self-sufficiency and think himself a mockery."

Monday, 19 May 2008

The NHS needs YOU! ... No, not you doctor!

“Am I going mad, or did the word 'think' just escape your lips?”

You don’t have to be a doctor to join the NHS'economics degree. Last month, Orchard marked a decade with the NHS. At 32, he is deputy director of finance, information and performance with Bournemouth and Poole Teaching Primary Care Trust, an organisation with a £500m budget. He earns £74,000, has 26 people under him and hopes to make it to finance director (salary up to £130,000) in the next few years. ... he played a key role in helping a financially failing trust turn a £2.5m deficit into a £2.5m surplus and was an acting director of finance for six months. ...

'If you knuckle down, you can make a name for yourself very quickly'

One of the myths about working in the NHS is that it’s all doctors and nurses, but they make up less than 40% of the work-force,” he said.'

“There’s constant variety with a new challenge every day and you can make a real difference to a patient’s life,”

From the comments made by the public:

That is more the starting salary of both a junior doctor (£21,000 effective after EWTD) and junior nurse (~£19-20,000)

Quote- less than 40% of NHS staff are Drs and Nurses. (ie over 60% of NHS staff are not directly involved with patient care, but nevertheless get directly involved in controlling those who do.)
I can see how the NHS "manages itself!!", and why Drs and Nurses become so disillusioned.

I'm a speech & language therapist working for the NHS. I started on £19166 in 2006 and I'm now on £20261. It made my blood boil to see how much more non-clinical staff make than me! Not because I think they're not worth it, but rather that my job and others like me seems to be undervalued.'

I have no comment! But ...

“When we remember we are all mad, the mysteries disappear.”

Sunday, 18 May 2008

One way ...

“For me, singing sad songs often has a way of healing a situation. It gets the hurt out in the open into the light, out of the darkness.”

I heard on the grape vine that Professor Darzi frequents medical blogs as well as 'allied' blogs regularly. Of course one can not be sure that he does, but by the same token, one 'hopes' he does. That is if he really wants a true feel of the situation on the ground before publishing his report in June.

Lord Darzi has also been given the task of looking into training for the juniors as well as reviewing the whole of 'our' NHS. It is therefore important that he gets a true feel of the insecurities felt by all doctors at the moment including the juniors. For those, the most important worry is of course, the lack of enough training posts for this year and way beyond. There is also the insecurities felt by most junior doctors with regards to the direction of where certain specialities are going. Especially surgical specialities.

A whole year plus have already passed since hurricane MTAS and the ensuing carnage of 2007. During and since then, there has been reviews upon committees upon responses and more meetings, reviews and reports of all levels. Investigations, more investigations and loads of money spent on same. But, where are the fruit of all this?! How many juniors have actually benefited since the start of all the investigations, the reports and the reviews?

... NONE!

On the contrary, there is a decline from the horrible situation of 2007. Training opportunities are much less and competition ratios for 2008 are much more fierce than in 2007! Deaneries are making mistakes that remain hidden because nobody knows about them now that selection is local. More doctors are affected but are not coming out to tell of what is happening because of the staggered on 3 phases appointments. So, they all keep quiet .. hoping ... maybe next round ... or the following .. Absolute chaos and absolute agony! ...

This makes me wonder,

How many training posts could have been created for the money spent on all the meetings, reviews, committees, reports and responses?

How many young doctors could have been spared the agony of the endless wait had this happened?!

The juniors started medical school on the 'promise' that they were joining a career that has only ONE direction; to become and work as doctors. only to be met with a 'Road closed' sign after spending years and years of sweat and hard work following their dream and 'expecting' the 'promise' to be fulfilled but in many, many cases, this did not happen! This IS betrayal.

If the government can afford to spend on meetings, investigations, reviews, committees and reports and responses, as well as desperate IT projects, re-organising and reforming, why can it not spend on people?! fulfilling the promise it made when it hand picked the creme de la creme of this generation for what it promised to be a one way system?! Why is the 'road closed' sign up now that the juniors fulfilled their part of the promise?! Why is the money never there when the 'human' element is involved but is in abundance when humans are not in the equation? Cuts and rationing?! Britain is one of the richest countries in the world! Surely, Britain can afford to take care of it's own 'people', especially it's own children .. if only for the sake of it's future?!

Even many of those with training posts have no idea about the future prospects for the specialty they have chosen, or, rather, were allocated to by the MTAS robot. To give an example of the dire uncertainty, a very junior doctor told me that one consultant, who is involved in workforce planning, told her that in future, each consultant, even consultant surgeons will only have a team made of him/her and two specialist nurses and this is it! That this 'team' will be responsible for the theatre as well as pre and post ob care! She asked how will the juniors be trained? But there was no answer as the said consultant did not have a clue! .... Is this rumour true? Will someone come forward and put an end to all the deomralising rumours and speculations by telling some truths about real future prospects?

Maybe Lord Darzi should visit a hospital under cover to find how low morale is among the doctors of all levels. I don't know much about the senior staff but I do see many juniors and NONE of them feel secure or optimistic about the future! Whether they are in training or are still waiting.

... and, everybody who is anybody keep saying that we need more doctors!

I have always admitted my ignorance about medicine and medical politics since day one and this far, all I know is what I have personally been through because of MTAS and my own son's experience last year plus what I read on medical blogs, medical websites and the media. However, what I find amazing is that I am not the alone in my ignorance. That those who are supposed to know don't have a clue and are almost as ignorant about what is going on too! ... that includes those up to the highest level, or so it seems to me! It is very obvious that nobody has a clue about how to untie the current knot!

Well, let ignoramus tell you. Of course you know about:

'Every action has an equal reaction in the opposite direction.'

All we need to do is to apply this beautiful law of 'motion' to the current situation, if we are to 'move out' of the mud hole we are in ... and, thank god for Newton and his law..

There is no other way apart from creating a number of training posts 'equal' to those lost to overseas applicants in 2007 ... Law! Proven!


It doesn't matter what you do, the number of committees and reviews and responses and investigations ... this is the ONLY way to solve the current mess! Otherwise, trouble will be carried forward year after year, breaking the heart of many a beautiful young and aspiring doctor on the way. Spend no more on committees. Instead, spend on people!

And, please, don't anyone even mention the word 'committee' again! it gives me the shivers! I have devoloped severe 'comiphobia' ...

Now, let's await Lord Darzi's 'review' ... and the two 'responses' ... :-)

The situation now is way beyond low morale, you now have a 'desperate' workforce on your hands Lord Darzi ... Your soldiers are sick ... Please heal , Doctor Darzi

Will Dr Darzi open the closed road and let the ONE WAY traffic flow again? Will he create those training posts to save his fellow hard working doctors caught in the middle of this mess?! .... I sincerely hope so ...

"Be an opener of doors for those
who come after thee ..."

Saturday, 17 May 2008

Happy Birthday Dear Alan ...

"It's not the years in your life that count. It's the life in your years.”

appy Birthday Mr Johnson

“We are born to inquire into truth; it belongs to a greater to possess it"

Friday, 16 May 2008

Things to do with 'A' degree ... in Medicine!

“The virtue of the camera is not the power it has to transform the photographer into an artist, but the impulse it gives him to keep on looking”

Career advice for junior doctors

Caught in the MMC debacle? Got 'A' degree in medicine? Loads more qualifications but No job on the horizon?

Don't despair!

There are lots of 'things' you can do with 'A' degree in Medicine.

For example, you can ...

Sit tight and apply next year

... Or, hop along to Ausatralia and get a chance to do some doctoring

.... or, maybe use your 'extensive' medical knowledge to sell 'stuff'

... Or use your 'transferable skills' and do Anatomy demonstrations ...

... Or, dare to start your own Business? ....

You 'do' have very high IQ, so, think 'positive' and 'Innovate!' ...

...Or, better still! Change career! ... Become a politician instead ...

You don't even need your 'degree' for this and if you ever mess up, you'll 'always' get away with it.

*** Success and riches ... ***


Good luck ...

“There is only you and your camera. The limitations in your photography are in yourself, for what we see is what we are.”

Thursday, 15 May 2008

... One year on ....


“The best performance improvement is the transition from the non-working state to the working state.”

62. Posted by Dr EM on March 09, 2007 05:54 PM

"Choose MMC. Choose MTAS. Choose a region. Choose a career. Choose a f***ing big lottery, choose portfolios, on-line application forms and years of uncertainty. Choose a cut in training posts, career choice and job security. Choose FTSTA's no one knows anything about, middle grade rotas being run by juniors who've never worked in the specialty before, foundation programmes you have no control over, and hospitals you don't want to work in. Choose being treated by 'trained doctors' rather than 'doctors in-training', even though the average consultants training hours have been cut from 40,000 to 10,000. Choose Hospital At Night and no-one knowing the patients anymore. Choose being an SHO lost in the middle of it all, with nothing but a sparsely updated web-site to inform yourself. Choose seniors who know nothing about the system and seem powerless to influence it. Choose an internal office with no windows in your brand new PFI hospital while the doors fall off and middle managers sit in their swanky boardrooms munching on biscuits that your taxes are paying for. Choose paying £10 a day for the privilege of parking at your work-place while you work non-compliant rotas and get bullied into lying on your EWTD monitoring forms. Choose sitting at that PC filling-in mind-numbing, spirit-crushing objective assessment questionnaires. Choose PMETB-approved curricula and competency-based assessments no-one has properly validated. Choose your third choice career path and wondering who the f*** you are on a busy post-take ward-round morning. Choose rotting away at the end of it all, pushing your last in a miserable Non-Consultant Career Grade post, nothing more than an embarrassment to the under-experienced, 'fit for purpose' FY's you've trained to replace yourself. (Don't) choose your future. Choose MMC…"

Posted by AR on March 09, 2007 05:49 PM

Q: How do you progress from Headboy with 4 grade "A"'s and the school top performer award to out of work with £40,000 of debt - in just 9 years? A: Train to become a junior doctor.

Posted by Dr G on March 09, 2007 05:00 PM

Yaya: I would love to see Hewitt and her "team" answer the same questions! After all: They did make a big, big mistake, Their "Creative thinking" :-) ended up in causing havoc and destroying lives and livelihoods, They are upset and very angry at the reaction and opposition to the "Monkey" system they impose, As for time management, well, they just about "manage!" They managed not to speak or meet with anyone who dares to voice concern! They stick to their "Creativity" do not admit the mistake, do not react at all under pressure, nothing! If the NHS was a patient and they were the doctor, it would have passed away long time ago! .... Maybe it already has!

(Of course Yaya meanz 'mama' Dr G ;-)

77. Posted by Dr "Give me a frickin chance Patricia". MRCP, BSc, PhD on March 09, 2007 10:30 AM

Like many junior doctors I have lost all confidence in this crazy system. My situation is slightly different, but I can still speak for many. I DON'T want a job in August 2007 or even 2008....this crazy system is making me apply for a job which I will potentially start in February 2009! Like many doctors I did fairly well a medical, BSc first class honours, MRCP earliest opportunity, publications, worked in some of the UK's most sought after jobs and recently I was awarded a £250'000 MRC clinical training fellowship to do a PhD. In other words I've jumped through all the hoops, ticked all the boxes and worked very hard in the process. Why? Because I "was" motivated, I "had" a vision, a goal, something that I have essentially sacrificed the last 11 years of my life for. And what for - a system that is so politically correct, so superficial, that provided you have a degree in creative writing you can join the "interview club". Where is the reward in that! This is where the problems lies - I may look good on paper (degress, fellowships etc. etc. etc.), but that means NOTHING in the present system. Research is not valued. Academia is not valued. Being slightly "different" is not valued. Future specialists are destined to molded into clones, teams will be made up of identical players. Read between the lines of MMC - We don't care how competent you are now. By the end of your ST6 training you will all have completed your "competencies". You will therefore be fit for purpose, fit to work in the great NHS "factory". Output will be good, targets will be met, tax payers will be happy. For this to work, you must however have a certain "personal profile" - quite literally the ST3 doctor profile. You will all be identical. You will eat, drink, sleep and shi*t political correctness. Those that deviate from this "profile" will be dealt with. Welcome to Patricia Hewitt land. Lets just scrap this crazy system before we all turn into robots. For those of you in the "interview club" - well done. BTW, speaking from personal experience - the questions are just as superficial as those on the application form, but don't be mistaken - this is NOT an interview for medical school - in four years you will be consultants .........

Posted by Dr "Give me a frickin chance Patricia". MRCP, BSc, PhD on March 08, 2007 11:57 PM

Just had my ST3 interview. "Well, then, why do you want to be a **^&*^ist?". "Are you a team player?". "How would you resolve a dispute with another member of staff?".................Hello..... I'm applying for an ST3 post, not med school. How on earth can anyone distinguish between candidates on the basis of these questions............ Why don't we all log onto the MTAS website and hit the "withdraw application" button - MTAS would crash and Patricia would get the sack.

99. Posted by wamah on March 08, 2007 05:52 PM

I am a mother of a very bright young doctor who has not been shortlisted. I also have 2 medics in my family who are currently very dismayed and confused. We are all demoralised and I want to do something to help. It is time those who help everybody get some help and support themselves. Failing to see any reporting of this fiasco anywhere apart from here and I deeply thank The Telegraph for that, I contacted Channel 4 last week through their News forum but their reporting on the problem was very minimal. I can't understand why the BBC didn't even mention the problem! What are we paying TV licence for then if the organisation does not even report matters so important to society such as this?! I am joining the march on the 17th March and urge everybody affected/supports to come along. The medical profession was too busy giving their all on all levels to their patients, they forgot about themselves. Their unions are hopeless and no one really cares. It is time doctors found an Arthur Scargill to represent and speak for them! You and I and ... Anyone out there?!

--- of course wamah meanz 'mama' too ....

180. Posted by Yaya on March 07, 2007 01:46 PM

Patricia Hewitt and her "Team" should be made to fill a similar application form to re-apply for their jobs. With the current system, junior doctors do not know anything about where, how much or a job description, nothing. According to this, Patricia Hewitt may end up managing the Ausie health system! Australians beware!

... 2008

Apart from no Hewitt and no MTAS, any improvements?

“Consistency requires you to be as ignorant today as you were a year ago.”

Wednesday, 14 May 2008

... a lullaby ....

Over in the meadow, in the sand in the sun

Lived an old mother frog, and her little toadie one

"Wink!" said the mother; "I wink!" said the one,

So they winked and they blinked

In the sand in the sun

Over in the meadow, in the pond so blue,

Lived an old mother fish and her little fishies two

"Swim!" said the mother; "We swim," said the two

So they swam and were happy

In the pond so blue.

Over in the meadow, in the nest in the tree

Lived an old mother bird and her little birdies three

"Sing!" said the mother; "We sing," said the three

So they sang and were happy

In the nest in the tree.

Over in the meadow, beneath the pond and the tree

hid a really ugly monster who lived deep in the sea

"KILL" ragged the monster; "I'll KILL" most of thee

... and so he killed loads of animals who lived happily by the sea ....

Tuesday, 13 May 2008

Humbling ...

“If in barbed wire things can bloom, why couldn't I? I will not die, I will not die.”

It's nearly 6 o'clock in the morning but I can not sleep. I don't sleep early but never stay up to this early hour unless there is something really disturbing me, then I keep thinking about it and no matter what I do, I can't switch off.

Yesterday, my daughter returned from work with a friend who used to be in the same year as my eldest son throughout medical school. She wasn't a close friend but I have seen her a few times before with the last time about three years during the final year. This young and very quiet woman comes from a modest background. She only has one brother who is about 10 years younger. I think he must be doing his A levels now. We all got talking and she told me she got an FTSTA last year but got no interviews for a job in August 2008 this far. I asked where she applied to and she said she applied to different specialties with the London Deanery only. I commented that she is limiting herself by applying to just one deanery who also happens to be very popular. She then said that she can't apply elsewhere because her father died in January . She is now the main earner in the family and with a mother and a younger brother, she is not at liberty to move anywhere even in pursuit of her own career. I asked what she intended to do and she said that she is applying to round 2 ..

I actually meant to ask what is she going to do if she doesn't get a job with the London deanery this year ... I did not ask again.

Do deaneries take circumstances like these into account when deciding on applicants?

After she left, I kept on thinking about this family, what are they going to do if she is not suited by August? I then went online and found this year's job numbers and competition ratios for the London deanery. It's a truly horrifying table.

ACCS, for example; at ST1 level, the deanery has 79 jobs and 1143 applicants. The deanery then decided to invite only 83 applicants for interview! In effect, the deanery decided on who will get the posts before they even sent those interviews! How overwhelmed is the overwhelmed deanery! How does the deanery decide that only those selected were the best? Isn't this a mockery? ... Judge the rest of the table yourselves ...

At ST2 for the same specialty, the deanery has 9 jobs and 150 applicants but only 6 were invited for interview! That is 4% of all applicants at this level! How do you explain this?! 146 or 96% of all applicants were deemed 'unsuitable' based on their application form alone?! Of course we know the London deanery uses and has been using the white boxes for the past decade as Professor S Heard told the HSC, so yet more and more excellent doctors are being 'clinically' judged based to their ability in creative writing! I can't find the link but, the deanery said somewhere on it's website that, because of the overwhelming number of applications it received, that some applications maybe considered based on qualifications only and not the boxes, so 'some' would have been judged with the white boxes and 'some' based on their qualifications only! ... The deanery says that it is changing it's application form for round two and is asking all applicants to submit new applications even if they have applied to the same specialty in round 1.

Has the deanery done away with those boxes? Especially since the HSC recommended that they are a 'creative writing' exercises? Are there any jobs left for round 2?!

Back to the young lady in question, What will happen to her if she does not get suited in round 2? How will she feed her family? She has already done an FTSTA1 but as far as I understand, to even get a career post, you need to have at least an FTSTA2! Australia is not an option!

See why I can't sleep? ... I just keep thinking, is there any humanity left in this 'modernised' world of ours?! ...

D@mn it! :-(

“It is lack of love for ourselves that inhibits our compassion toward others. If we make friends with ourselves, then there is no obstacle to opening our hearts and minds to others.”

Sunday, 11 May 2008

No mystery at all ...

“The sole meaning of life is to serve humanity.”

No mystery. Like you, I knew I am carrying a healer and a teacher

A man who will leave his print on the whole of humanity.

I am a true fan of the Professor

Saturday, 10 May 2008

Hey! Teacher! Leave them kids alone!

“Be an opener of doors for such as come after thee.”


“The mediocre teacher tells. The good teacher explains. The superior teacher demonstrates. The great teacher inspires.”

Thursday, 8 May 2008

The HSC report is out

“It is understandable. But there is something bigger at stake for the government: its ability to modernize the political system.”

HSC report on Modernising Medical Careers


The Guardian

Lack of leadership for doctors crisis


Management of junior doctor reforms "totally inadequate"

"the DoH did not take responsibility for problems resulting from MMC and that the government failed to prevent open access to training for doctors from across the globe in both 2007 and 2008.

The committee says this was "inexcusable" and that it has resulted in hundreds of UK graduates being unable to continue their training.

The government's management of migration and doctors' training places is branded by the committee as "poorly planned, badly communicated and inadequately coordinated".

Its report concludes that this issue must be resolved as a matter or urgency.

In January the Tooke Review of MMC recommended that a new body be created to oversee medical training.

'This proposal has been described as "problematic" by the health committee, which instead advises that the MMC Programme Board should be supported and its independence strengthened.'

The Telegraph

Minsters 'ignored' junior doctor warnings


The Times
"MPs have criticised the Government over a training scheme that handed NHS jobs to foreign doctors at the expense of British candidates."



Handling of junior medics 'inept'


'Inept' ... then, I wonder ....

Did the HSC recommend that:

No British junior doctor or medical student should suffer ruin because of this mess?

“The problem is, the Endangered Species Act does need to be modernized, ... but the people in charge just want to do away with it.”

Wednesday, 7 May 2008

Exam blues ... mine ..

“Go ahead and play the blues if it'll make you happy.”

- "Maa"

- "Hello!"

- "I'm bringing some friends home with me, is there any food in the house?"

- " Friends?! What friends?! Your exams start on Monday son!"

- "This IS for the exams! We have to write up our group project together! Is there any food in the house? Yes or no?!"

- "Aren't you a little late writing up this project?!"

- "Nevermind this now mum, what have you cooked ?"

- "How many 'friends' are you bringing with you?!"

- "7"

- "SEVEN?! :-O"

- " Maaa! Pleeease .. just make anything you like, anything at all ... pleeease"

- "OK! I'll quickly make some spaghetti then .." ... he's the youngest ...

- " S-P-A-ghetti?!! Every time I bring friends home with me, you make spaghetti! Can't you do something else?"

- "Well, if you had told me ...." interupted

- " All the other mums don't need telling, they always have something ready when we go there!"

- " I too have food ready but not for seven more people! .. This is not Pizza Hut at 'your' service, huh! ... "


- " OK, ..... I am calm son ... I'll make spaghetti AND a large bowl of salad"

- " But one of my friends is a vegetarian mother, you can't just make her eat salaad!"

- " No! Of course not! .. I'll make some mushroom sauce as well"

- "MUSHROOM! Is this all?!"

- "Well, ... I meant mushroom and green lentils sauce "

- " Ok, but make something sweet as well, this whipped cream triffle you make will do ... will be with you in 20 minutes .... Bye"

“Spaghetti can be eaten most successfully if you inhale it like a vacuum cleaner.”

Tuesday, 6 May 2008

Your maths don't add up Prof!

“The oldest, shortest words - "yes' and "no" - are those which require the most thought.” .. Pythagoras

I can not control the font for some reason! Excuse me ...:-)

Pythagoras once said;

"number is the ruler of forms and ideas and the cause of gods and demons."

I happen to really believe in this Pythagorean quote and am certain that any argument must conform to the rules of reason, otherwise, it's maths never adds up and the argument becomes obsolete. Simply put,

no 'reason'
= foolish

Now let's see if
this man's claim about doctors' unemployment makes any sense, see if his claims add up: ...

Does it matter that medical graduates don’t get jobs as doctors? No

By Prof Alan Maynard ... as usual! Remember his assistant
Karen Bloor?

"The government, as the main employer of doctors in the United Kingdom, is responsible for planning the medical workforce proficiently in order to deliver patient care. This requires it to model demographic trends, specialty needs, skill mix, technological change, and resource consequences. However, its manifest failure to plan efficiently does not create the responsibility or need to guarantee medical graduates employment."

Sounds like giving credability to 'getting away with murder', doesn't it? ...

Doctors cost hundreds of thousands of pounds to train. This training gives them specific skills as well as transferable skills. The training expenditure is a sunk cost—that is, once spent it cannot be retrieved.

The Prof is admitting that the money will be wasted if the doctors became unemployed after spending £250,000 on training each one of them but of course, these doctors then go on to treat patients from ailments and disease that would cost lots more if left unchecked. So, although doctors do not make money as such, their service does. Therefore, the expenditure on their training will be considered a 'sink' fund only if they are unemployed. Hence, doctors should all be employed if the government is to get a return on its investment.

If medical graduates are unemployed this loss can be mitigated by their finding employment in other sectors of the economy, just as graduate lawyers do if they are unable to find jobs after academic and practical training.

Now you are getting into deep territory Prof, treating doctors the same way as lawyers or throwing doctors into the market place and just 'hope' to get 'a' return on the investment is flawed. Of course, training lawyers does not itself conform to the same rules as when you train a doctor; first, lawyers do not cost £250,000 each to train. Then, lawyers are not under the mercy of the one monopoly employer but can move freely between public as well as private employers or, indeed, set up their own businesses if they wish. Third, lawyers were not 'commissioned' and trained against a rigid set of criteria like doctors, hence lawyers have more transferable skills built into their education unlike doctors who have very limited number of transferable skills by virtue of the needs of their own training which concentrates on the treatment and management of disease only.

'Medical graduates, like all other graduates, gamble when they invest in their training. Their success brings riches, but if they fail due to lack of skills in making career choices and because of their inadequacy as doctors, they are no more eligible than other graduates for compensation in terms of job guarantees.'

Adequate/inadequate?! Don't you know the government appologised, on numerous occasions for its inforcement of the MTAS system against all 'professional' advice?! .. It seems you haven't! But MTAS was all over the news last year!... Maybe needing an ENT doc! who knows!

... and, Gamble?! Where did you get this from Prof?! In no occasion has medical schools EVER warned applicants to 'medicine' that they are gambling on their careers or that they are applying for 'A' degree course that has a variety of transferable skills other than doctoring! The majority still publicly advertise that the teaching of medicine will only lead to 'doctoring'
to this day:

Brighton Medical School undergraduate prospectus for 2009

From above prospectus:

In recent years there have been radical changes in the way medicine is taught.
As a new medical school, BSMS has had the opportunity to create a truly distinctive and innovative programme that will prepare you for the wide range of career opportunities you will face when you qualify as a doctor. Our programme is designed to introduce you to patients at the earliest stages of your training,to help you to develop your interpersonal and communication skills and to provide you with a solid foundation in science that will stand you in good stead whichever branch of medicine you decide to follow.

BSMS is a small new medical school. Our mission is to help you to become a competent, caring and compassionate physician; a doctor who is really in touch with patients and their families. If you eel you have the qualities we are looking for we would welcome your application. I am delighted that you are considering a career in medicine It is a demanding profession but one which repays the hard work and dedication it involves through the rich variety of careers it offers and the satisfaction of knowing that you are making a positive contribution to society."

"At Brighton and Sussex Medical School we aim to sustain your enthusiasm for throughout your studies and on through the whole of your career in
medicine. Our mission is to help you to become a competent, caring and compassionate physician; a doctor who is really in touch with patients and their families.

Then the Prof goes on:

Medical school training can be likened to studying 50 GCSEs, requiring a breadth of knowledge but needing little application of the great intellectual proficiency of the academic elite that is recruited to medicine.

OK, ok! If you ever get a heart attack, god forbids, we''l get the 50 kids of class 11F of the Sunrise High school to take care of your affliction! Meanwhile, please answer those 2 questions then Prof:

1- How many GCSEs would you estimate for the 3 year undergraduate study of Economics?
your field so you must know!

2- Does this mean that in your 'expert'
opinion, Medical schools should select the dumb only from now on? Those who were never able to get into medical school so had to make do with a run down three year course in economics instead?

'He then goes on to suggest a 'nurse led Primary care provision' .. etc, etc, then this:

However, the over ambitious expansion of medical workforce numbers by the Blair government will inevitably lead to some unemployment, raising an inevitable middle class furore which has to be resisted. The purpose of the NHS is to deliver patient care that is compassionate and efficient. It should not guarantee the employment of medical graduates or any other group regardless of patient need, personal skills, and the finite resource constraints of the NHS.

How can the NHS be efficient and compassionate without regard to patient needs?! One would expect a Prof of his calibre to consider some reasoning before making these amazingly contradictory statements!

... and, a middle class furore, huh?! You bet

What else to fight for if one does not fight for their own children?!

I know money for academic research is hard to come by but didn't know it was this hard Prof Maynard! ;-)

Was this whole fiasco really the result of a mistake in workforce planning?!

Why did the BMA allow this man to write this demoralising article in the British MEDICAL Journal?! Close to exam times too!

Are you listening Mr Brown?! Like you, we too are
'private' people who are not even in the public arena. There is no better way to gain us on your side than ensuring the security and prosperity
of our children.

Our children, those junior doctors' livelihoods is your responsibility PM. We've done our bit, please do yours ... and ... please keep away from the clowns and the imposters ... the demons!

The most guaranteed route to success, prosperity and peace ... and privacy

“Truth is so great a perfection, that if God would render himself visible to men, he would choose light for his body and truth for his soul”