Physician assistants

[Dr Noodle]

Because extra training for nurses will mean extra spending

New PA job role will also mean extra spending to hire them (dunno about training) and nurses pay for their own training (unless they work in a private hospital who may support them).

yes the govrnement did address it but how many people can actually go to medical school considering the amount of debt they end up with? some people can't simply afford to go.

This isn't really a valid point because there is still intense competition for places. Also, I have very little money myself but I will be applying for a student loan. The debt comes after college when you are earning over £15,000 a year.

It may work in the USA but is there a job shortage for doctors there?

[Dee41]

Originally Posted by Dr Noodle

New PA job role will also mean extra spending to hire them (dunno about training) and nurses pay for their own training (unless they work in a private hospital who may support them).



This isn't really a valid point because there is still intense competition for places. Also, I have very little money myself but I will be applying for a student loan. The debt comes after college when you are earning over £15,000 a year.

It may work in the USA but is there a job shortage for doctors there?

Nurses do not pay for their own training. They receive an NHS bursary as students and then when they secure jobs as staff nurses are sent for extra training as and when the NHS budget allows

[yeliab_cram]

The perceived need for "physicians assistants" is simply a sad reflection of the horrific workforce planning in the NHS over the last 5-10 years.

I say again, there is nothing inherantly wrong with any allied specialty taking on increased roles, however deskilling of the doctors is going to occur. Who is going to do the hard cases?

PAs are a short term solution to a problem driven by economics and i for one have a real problem with the long term implications of their introduction.

If there aren't enough junior doctors to staff the wards adequately, then what we need is either more junior doctors (although, i think we can all now see that that is a big problem, as the NHS cant actually afford to give them all specialist training) or to allow doctors to work outside of the EWTD without being subject to 150 hour weeks again.

[Dr Noodle]

Originally Posted by Dee41

Nurses do not pay for their own training. They receive an NHS bursary as students and then when they secure jobs as staff nurses are sent for extra training as and when the NHS budget allows

I meant extra degree training. Doesn't a nurse have to do an MSc in cardiothoracics for example, if they wanted to specialise in that area? That's what I was told by a nurse from NZ anyway.

[yazoo]

Originally Posted by yeliab_cram

If there aren't enough junior doctors to staff the wards adequately, then what we need is either more junior doctors (although, i think we can all now see that that is a big problem, as the NHS cant actually afford to give them all specialist training) or to allow doctors to work outside of the EWTD without being subject to 150 hour weeks again.

We have more junior Drs currently in training... We just have limited career opportunities for many of them...

Shame. And it is indeed a sad state of affairs.

[Diya]

It is a real shame indeed. How cost-effective is it training all these medics and then letting all their skills go to waste when they get to ST level and dont get posts in the specialty that they're passionate about and skilled in?

[yeliab_cram]

Its the maths that does my head in... you can just see the meeting where someone came up with this stroke of genius:

NHS MD Bloke: So, gentlemen, the EWTD is coming in, and all those house officers are going to have to go from 100 hour weeks to 48 hour weeks over the next few years. thats going to screw us.

Junior Management bloke: Cant we just employ twice as many of them then?

Middle Management bloke: Unfortunately, these doctor people don't grow on trees...

Junior Management bloke: So just train twice as many...

NHS MD bloke: Genius

Tea Lady: but what will you do with all the extra junior docs after two years when they want training jobs?

NHS MD bloke: Shut up, you. Where's the biscuits anyway?

[Anjoo]

Yeliab Cram

do you really think doctors will want to revert back to 100 hour weeks? I watched a series of programmes on Sky, it was called: "Doctors Twenty Years on" and it follows the story of a group of doctors within the 20-years of their life in Medical training, becoming a junior doc then working their way up, and it showed how the 100 hour weeks affected them mentally and their social lives... it was Sad.

[James]

No one wants to go back to 100 hour weeks, but 48 hrs per week is simply no enough for training.

I did 72 hrs/week as a PRHO, regular sets of nights and every third weekend. Yes it was hard going, but I learned so much. You simply can't beat looking after 3 sick patients at 4am when whilst covering 700 ward patients by yourself - That is how you learn true time management, prioritiazation and speed. And yes, some good doctors couldn't cope with the pressure, but that was how you separated out those who could cope with hospital medicine, and those which could not. On my first day as an SHO, 1 year out of med school, I was the RMO at a city center teaching hospital, taking all the referrals, running the acute medical take and helping out the A&E docs when they got stuck with sick medical patients. There wasn't even a medical registrar on site after 10pm. But I coped, because I had seen it before, I had learned what to do at 4am with a sick patient and no back-up.

There are now hospitals where F1's and F2's don't even do medical nights - and they are wondering why the ST1's can't cope with the job?

Post-graduate medical training is in melt-down, and the introduction of PA's, nurse practitioners etc. is only going to make things worse.

[Anjoo]

James

But didn't doctors protest against the amount of hours they were having to work tho? why did NHS decide to change the working hours.. I'm just curious to know.