Why should i care about MMC???

**yeliab_cram** · 16-06-2007, 09:14 PM

Originally Posted by Mattie

When I applied to med school I looking forward to the SHO years. Not really because of the long hours but because you get to try your hand at loads of different specialties without having to decide too early. Now there are going to be consultants who aren't really 100% dedicated to their specialty and with much less training! I know they aren't going to be totally incompentent but they won't have those years of experience.

I feel precisely the same way. I want to do surgery, but i wanted to gain general surgical experience as an SHO. Do a bit of ortho, bit of paeds etc. Things i probably wouldn't go into, but all very valuable experience. You cant really subspecialise before you have good general exposure. Its just learning to run without even thinking about walking.

Remedy UK is also good for general rantings:

http://www.remedyuk.net

**yeliab_cram** · 16-06-2007, 09:20 PM

Originally Posted by loratwopointone

I know the doctors coming through MMC aren't going to be rubbish

Yes we are

**loratwopointone** · 16-06-2007, 09:35 PM

Ach.... you know what I meant!

**yeliab_cram** · 16-06-2007, 09:43 PM

I do, but we are going to be rubbish! Medical school has been dumbed down, junior doctor training has been dumbed down, SHOs have been removed, ST training has been shortened and moved to a competency based system rather than an apperentiship.

Factor in the EWTD, the short staffing that is going to occur from August 1st and you have to wonder if we are going to be anything more than protocol driven practitioners... ie glorified specialist nurses.

**Shakey** · 16-06-2007, 09:46 PM

i was just wondering, but surely having more consultants would surely cost more to the NHS budget than having them as junior doctors, cause as a consultant don't they get paid more! Please Correct me if i'm wrong.

It's also a bit of harsh way to treat them!

**yeliab_cram** · 16-06-2007, 09:48 PM

junior doctors cost less than cnosultants, but can do less, and do not stay junior doctors for very long as they progress up the training ladder - eventually becoming consultants.

The NHS needs more consultants to provide appropriate care for the growing population. And yes they are expensive. But you can't simply have lots and lots of junior doctors, who dont get paid well and work very hard, if you are not going to fund enough consultancy posts / GP posts for them.

Otherwise you are expecting them to work for you like slaves for 5-10 years then throw them out with nothing. But that is what is about to happen to 18,000 junior doctors come Aug 1st 2007.

**anvilhead** · 17-06-2007, 03:34 AM

Seriously Marc, MMC isn't as bad as you make out. I think you will be pleasantly surprised when you come to apply for your foundation jobs. I can pretty much guarantee with your background you will get your first choice job in your first choice hospital; most of my friends did and there are some pretty good rotations available (academic vascular job might be appealing for you??).

I am hoping by the time I apply for ST training (just qualified) it will all have sorted itself out. The government has got to respond to what the profession want. There is certainly no point trying to put first years or people applying for medicine off the career based on what is happening now. It is almost certain the system will change again, then again, then again, by the time they will be experiencing it.

**yeliab_cram** · 17-06-2007, 03:54 AM

Hey anvilhead,

i'm not trying to put anyone off, i just think we owe it to ourselves to be aware of the current situation. Sure MTAS/MMC didn't do too badly for the 5th year medics, but it didnt half **** over a load of SHOs - and a not insignificant number of my older mates. I am constalty amazed by how many people (medics, applicants and all) are completely clueless about it.

I agree with u, things are going to have to change (or the NHS will stop working). I'm just trying to encourage people to take an interest in what is going on. After all it is going to be us who have to live through whatever changes come next to try and fix the MMC mess! And lets be honest, hearing patsy talk does make you want to hit her.

As it happens, well predicted, i'm thinking about the vascular job. Not decided yet though. Know anyone doing it this yr?

Not to be rude, but who are u?

**yazoo** · 17-06-2007, 01:07 PM

The training side of things is just insane.

Dumbed down med school. Tick - agree! And the standards may get even worse if a national qualifying exam is brought in... One that 95% people must pass to keep the number of FY1s reasonable...

House officer equivalent - no on-call??? What's this all about? Most of my skill/knowledge development has come out-of-hours. This includes - well, everything! The unconscious patient, the one vomiting blood, chest pain that sounds cardiac. How do I manage these patients, deal with low blood pressure, cannulate someone with low cardiac output under pressure etc etc. It's not that you don't encounter these things during the day, it's that you are by yourself much more out-of-hours, and you are called about these things all the time rather than once a week.

So then you go to FY2. Where you will likely be on the hospital at night team (but possibly not until ST1...). So you are an SHO equivlanent, but you've done no on-call. How does that work? Badly, I assume.

And I forget, at the beginning of FY2 you have to select your ST specialty. On basically little more than med school experience. And I could not tell you the number of people who change their minds about what they want to do during FY1/FY2 - maybe 50%, I would say. But that is based on having out-of-hours experience, and understanding what type of on-call rotas you are willing to work in the future. You discover much more about which aspects of medicine you hate, and this is vital in career selection. But the future juniors won't even have this... Perhaps the new entirely random MTAS works well within this overall chaos

Then what happens if you

1. get a job you don't like

- nobody really knows the answer to this just yet - it really may NOT be possible to switch...
2. don't get a job at all

I am thankful that I am an FY1/FY2 who gets to do on-call (and I am thankful I have banded posts). I am thankful I am getting to do the FY1/FY2 jobs that are my first choice. I am thankful because I am not an FY2/SHO this year, and have not had to experience the first miserable year of MTAS specialist applications.

This rigid, inflexible and accelerated training system will benefit nobody. And don't expect it all to be sorted out by the time you get there, even if your just applying now. It won't be. For one, thing, the huge increases in med student numbers have not been factored in beyond junior level. But the main thing is that the number of consultant posts will not rise proportionately (or even close to it).

It will take years to come to some sort of eqilibrium in the age of MMC.

**yeliab_cram** · 17-06-2007, 01:27 PM

As anvilhead says, likelyhood is, once this years blip of F2s and SHOs is over, is is likely the system will work, in so far as we get some form job. but thats not really what the long term problem with MMC is.

My concern is exactly what yazoo describes, that essentially when we get to consultant level a) are there going to be any jobs whatsoever, and b) are we really going to have anything like the expertees of the current constultants. If not, what will happen when they all retire?