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Medicine current affairs

Hello all,

I decided to make a thread that would discuss topical issues in medicine which might be relevant at interviews, so if anyone has any ideas or wants to start a debate go for it!

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What do prospective medical students think to the new contract for junior doctors? Would it change your career plans?

How would you feel about striking if you were a doctor?

I work in A&E as an SHO and would support a strike that maintained basic emergency care - do people agree with that?
Original post by jetbackwards
What do prospective medical students think to the new contract for junior doctors? Would it change your career plans?

How would you feel about striking if you were a doctor?

I work in A&E as an SHO and would support a strike that maintained basic emergency care - do people agree with that?


In a word: yes. Emergency care should obviously be maintained but the government is totally out of line on this and deserves to face public anger, which is most effectively funnelled by striking, I think. The public is not likely to notice unless they suddenly find that their hospital work is being delayed.

I would imagine that Wales and Scotland might become more competitive places for medical students looking to do their foundation training. The new contract has been rejected in Wales and (I haven't kept up with this) is likely to be rejected in Scotland too.
My understanding is that Scotland have also said they wouldn't introduce the contract.

We have had quite an issue getting the full message across to the public - I don't think people realise that an ST8 registrar is still a 'junior doctor'!
This would be a great interview question - checking knowledge about ongoing professional issues (some broad understanding about junior doctor careers) and leading into a real ethical dilemma (should doctors strike, when, and how).

Just as a tip, even if you are sure about what you think about an issue (in fact, particularly if you are sure), answer all such interview questions with...

"Well... on one hand the costs of healthcare are rising and the government has a duty to get the best possible deal for the tax payer... the new contract might also make it easier for hospitals to provide more medical staff at the weekends...

However... doctors are already under intense pressure and the government should treat them fairly because the NHS depends on a lot of good will and there is a very real risk that doctors will leave the NHS or avoid specialties that are already struggling to recruit...

On balance, I think that..."

Talking through a problem gives you time to think and will make sure you come across as balanced and considerate. It then almost doesn't matter how you actually conclude - you've already gained maximum credit with the interviewers. They aren't likely to ask questions with a clear cut "yes/no" answer and so you should acknowledge that, however strongly you feel.
Original post by Hydeman
Emergency care should obviously be maintained


Why?

The fire-fighters didn't when they went on strike.

When the tube drivers go on strike it costs us millions of pounds, money which could have gone into emergency services and saved lives. Yet they still go on strike and have excellent working conditions because of it.

Why are doctors different?
Original post by nexttime
Why?

The fire-fighters didn't when they went on strike.

When the tube drivers go on strike it costs us millions of pounds, money which could have gone into emergency services and saved lives. Yet they still go on strike and have excellent working conditions because of it.

Why are doctors different?


I'm with you on the Tube drivers. I doubt anybody could call the working conditions of junior doctors 'excellent', however. Tube drivers have a pretty cushy job that is ripe for automation. Doctor's are still a while away from that.

As for why firefighters didn't maintain emergency services -- I don't know. It would've been appropriate to do so in that case as well but, again, I'm not a firefighter so I didn't get a vote. Emergency services should be maintained because, if they aren't, people die. It will cause us millions of pounds as well as lives, and that's the difference.

The ones that I assume would be in the best position to go on strike would be those whose patients are well enough to stick to the normal 9 to 5 working day.
Hi everyone

It's a great idea to get up to speed with 'hot topics'. If your not aware of major news stories in healthcare - like junior doctor contracts - then it's hard to really be convincing about your deep interest in medicine.

As mentioned earlier in the thread, though, it's essential you are able to discuss these issues in a balanced way, even if you feel very strongly one way or the other. Make sure you articulate both sides and come to a reasoned conclusion.

If you are looking to keep up to date with medical news, then BBC Health, the Student BMJ or our blogs, including a weekly summary of medical news stories should help.

The Medic Portal
Original post by Hydeman
Emergency services should be maintained because, if they aren't, people die. It will cause us millions of pounds as well as lives, and that's the difference.


It will save us millions of pounds as medications are treatments aren't used.

It will cost lives, but so did the tube strike. It was just indirect via reducing the money to hire NHS staff. So are you saying that the only difference is that one is immediate the other isn't? Is that a good reason? Does the notion that us not working will cause death not a reason that the strike is more important and that the workers have even more right to strike?
(edited 8 years ago)
The shortage of GPs is a hot topic. Many GP training schemes can't recruit enough junior doctors and many GP practices especially in Scotland aren't managing to recruit new partners.
Original post by nexttime
It will save us millions of pounds as medications are treatments aren't used.

It will cost lives, but so did the tube strike. It was just indirect via reducing the money to hire NHS staff. So are you saying that the only difference is that one is immediate the other isn't? Is that a good reason? Does the notion that us not working will cause death not a reason that the strike is more important and that the workers have even more right to strike?


And what about the lost hours of productivity? Will that cost nothing? Those patients who miss out on treatment and prescriptions while the doctors are on strike aren't just going to disappear -- they're going to add to the regular traffic of patients to hospital afterward, creating a longer waiting list than is necessary. Those medications and treatments are going to get used eventually so, if anything, that's a net financial loss. It's only going to increase the workload for hospitals because they'll have yesterday's patients to deal with in addition to today's.

Underlined: essentially, yes. One is direct and the other indirect. I'm not a huge fan of indirect guilt. Most things these days are pretty interconnected so it doesn't really add up when you try to link the Tube strike with deaths in the NHS.

If we allowed indirect guilt to be taken seriously, just about any excuse could be made for any deaths at all.

I have to say, I'm slightly unsure about what your point is... :s-smilie: Are you saying that the junior doctors in the NHS should or shouldn't be striking?
Original post by Hydeman
And what about the lost hours of productivity? Will that cost nothing?


Well... you don't pay the doctor when they're on strike... and you pay them the same after they come back to deal with the mess so...yes.

Those patients who miss out on treatment and prescriptions while the doctors are on strike aren't just going to disappear


You'll find a lot of them will actually. Not all A&E attenders are massive heart attacks and major polytraumas.

Underlined: essentially, yes. One is direct and the other indirect. I'm not a huge fan of indirect guilt.


Wow really? I mean, I could see it if it was some obscure link via multiple steps, but its not. Its the government losing revenue -> the NHS has less money.

Most things these days are pretty interconnected so it doesn't really add up when you try to link the Tube strike with deaths in the NHS.


Surely things being interconnected makes it much easier to connect the government's lost revenue to a lack of nursing staff?

I have to say, I'm slightly unsure about what your point is... :s-smilie: Are you saying that the junior doctors in the NHS should or shouldn't be striking?


I am mainly being provocative for the sake of debate. I do think that doctors are being far too apologetic for going on strike though. If the government doesn't want a strike they should not be imposing ridiculous conditions on healthcare staff.
(edited 8 years ago)
Original post by nexttime
You'll find a lot of them will actually. Not all A&E attenders are massive heart attacks and major polytraumas.


Fair point, and one that I've had experience with while shadowing an FY2 doctor in an A&E ward. Not all of them will, no, but given that emergency care would be maintained in this hypothetical scenario (assuming I'm the puppet master), those people won't count anyway.

My point was that the NHS wouldn't make a huge saving ('millions of pounds' was mentioned somewhere) on not prescribing medication and performing routine treatments like you suggested. Those who have genuine need of treatment are likely to still need treatment after the strike is over and, if anything, the strike will just mean an increased backlog for hospitals. There are those who will go straight to A&E for minor things, yes, but I doubt people like that constitute any significant percentage of the people who're in and out of hospitals each day.

Wow really? I mean, I could see it if it was some obscure link via multiple steps, but its not. Its the government losing revenue -> the NHS has less money.


I stand by what I said: I'm not a fan of indirect guilt. Individuals may want to make decisions on the basis of who they might indirectly affect but I see it as a pointless exercise to hold people accountable for the indirect effects of their actions, especially when no intent is involved. Unless you could prove that Tube drivers striking = Tube drivers wanting to deprive the NHS of money, I'm not going to criticise them for that particular offence.

Surely things being interconnected makes it much easier to connect the government's lost revenue to a lack of nursing staff?


Connect? Sure. But as far as holding anybody responsible for the indirect consequences of their actions, even without numerous steps, goes, no, I'm not up for that.

Here's an imperfect analogy to explain what I mean:

Harry and Joe go to a party. Joe has agreed not to drink alcohol at the party so that he can give Harry and some others a lift home after the party. Harry gets hopelessly drunk and starts behaving very inappropriately and Joe, seeing this, refuses to give him a lift back to his house. Harry is left to walk home, a short distance away, by himself. He gets mugged on the way. Joe feels guilty about it when he finds out.

It's an imperfect analogy because, while the average person is likely to know that that is a potential consequence of not giving his drunk friend a lift in the same way that the average Tube driver can probably make a link between lost government revenue and less money for the NHS, the latter is more likely than the former.

But I hope you get the point that, in this situation, one cannot simply say that Joe not giving a lift to Harry = Joe being morally responsible for the mugging. That was not his intent, in the same way that it is not the intention of most Tube drivers to deprive the NHS of money. It wouldn't stand up in court and for good reason, in my opinion.

I am mainly being provocative for the sake of debate. I do think that doctors are being far too apologetic for going on strike though. If the government doesn't want a strike they should not be imposing ridiculous conditions on healthcare staff.


I see. :tongue:
Original post by jetbackwards
My understanding is that Scotland have also said they wouldn't introduce the contract.

We have had quite an issue getting the full message across to the public - I don't think people realise that an ST8 registrar is still a 'junior doctor'!


Hi,
Yes, I've heard about the planned cuts for junior doctors.
But what contract are you referring to if I may ask :smile:


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Original post by taysidefrog
The shortage of GPs is a hot topic. Many GP training schemes can't recruit enough junior doctors and many GP practices especially in Scotland aren't managing to recruit new partners.


Yes, I've heard about this to.
But why exactly is this?
Is it because of the high amount of tax having to be paid?


Posted from TSR Mobile
Original post by Bloom77
Yes, I've heard about this to.
But why exactly is this?
Is it because of the high amount of tax having to be paid?



I suspect that might be one of the lesser reasons. What other ideas do you have?
Original post by Helenia
I suspect that might be one of the lesser reasons. What other ideas do you have?


I'm not sure tbh, perhaps other specialities may be more interesting or attractive.
Additionally, the timeframe of training to become a GP is long, so I guess a load of GP's wont be created just like that.


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What do you guys think about the 'file drawer problem' which has been so prevalent in health sciences research (particularly it seems in medicine and psychology)?
I.e. research being biased in that positive research is published and negative results far less often - resulting in incorrect decision making by clinicians due to false information provided.
(Though I think they are soon putting in more legislation to force pharma and individuals researchers to push to publish null findings)
Original post by Bloom77
I'm not sure tbh, perhaps other specialities may be more interesting or attractive.
Additionally, the timeframe of training to become a GP is long, so I guess a load of GP's wont be created just like that.


Posted from TSR Mobile


GP training is the shortest of any specialty training programme (3 years post-foundation).

So why do you think it is not as interesting or attractive as other specialties? If you were in charge of fixing the recruitment problems, what would you do?
Original post by Helenia
GP training is the shortest of any specialty training programme (3 years post-foundation).

So why do you think it is not as interesting or attractive as other specialties? If you were in charge of fixing the recruitment problems, what would you do?


People are attracted to other careers because they can become true specialists, and can focus on doing one thing. GPs need to be integrated more into the health system, allowed to become specialists, and possibly given 3 day - 2 day contracts of hospital and primary work.
Most GPs really enjoy what they do, the reason we don't have enough is because we need more of them than any other doctor - allowing opportunity to properly specialise may entice more into the trade.




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