Foundation programme is changing - interesting read for medical students.
http://www.stfs.org.uk/sites/stfs/files/FAQs%20-%20Draft.pdfhttp://hee.nhs.uk/wp-content/uploads/sites/321/2014/02/Broadening_the_Foundation_V15-Final.pdfBrief overview:
1) Cut numbers of surgical and some medical FY1/FY2 posts !
"In terms of the redistribution of posts from specific specialties, it is likely that posts will move from surgery and, to a lesser extent, from medicine."
"retaining trainees, particularly in surgery, by converting some of their placements into integrated and community-facing placements"
2) target of 45% target for foundation doctors to do 4 month psychiatry post (22.5% FY1, 22.5% FY2)
3) target of 100% for everyone to do an 'intergrated placements' or 'community placements' by 2017
4) Other 'professionals' to take over the roles of junior doctors so they can do community placements
This is the most interesting part:
If posts are going to move away from acute trusts, how will the workload be covered?
"It is unlikely that new training posts will be available, so other types of staff will be needed, both to cover the workload and prevent impact on other doctors in training. The skill mix of the staff needed will obviously depend on the workload to be covered. Activities such as prescribing or discharging patients would need senior nurses (band 7 or above) or physician associates. Foundation doctors often spend considerable amount of time on inappropriate duties such as routine phlebotomy and clerical work, much of which can be supported by staff in bands 1-4."
Thoughts ?
From experience the major problem is that juniors and SHO rotas are understaffed in surgery and medicine, throughout the country, so cutting these posts seem short sighted the jobs will only get worse for juniors. The hospital is bankrupt and in a recession and band 7 nurses and physician associates (which cant prescribe!) are very expensive. There is no money to get even basic assistants for cannula/bloods in most places so I think it will be a bad time to be a FY1/FY2, especially in surgery. Yet another reason not to do core surgical training if you havent already changed your mind !!