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Early registration due to Corona crisis

My school has cancelled all our remaining placements and we already sat our finals two months ago. Why can't they graduate and register us early? Surely, I'm going to be a better doctor now and can be of more use even if it's just to free-up more senior doctors from basic ward work, than if I sat around until August without any further placements or teaching.

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Original post by Anonymous
My school has cancelled all our remaining placements and we already sat our finals two months ago. Why can't they graduate and register us early? Surely, I'm going to be a better doctor now and can be of more use even if it's just to free-up more senior doctors from basic ward work, than if I sat around until August without any further placements or teaching.

So
1. Graduation is up to your university, and they need to be sure that you've all met your GMC requirements before they send you packing. For some of us, that's about hours spend on the wards, for other it's exams, for others it's competencies, etc.
2. If you were graduated early, that's all you would be. Just graduated. You would be a BMBS, but you would not be on the register - that's the most important thing to note. You're not a legally allowed to practice doctor until you're on the medical register. The register has nothing to do with the university, the GMC makes the decisions about when they're registering you. They've said they're not doing it early yet, which I imagine has more to do with needing to thoroughly check that all the unis who did finals in final year have met the required standards.
3. We're all starting new jobs; we'll need inductions, to move, to get settled, get passwords etc. That's not really going to happen right now. So we could start our doctoring jobs in our current deaneries, but I imagine there are also a lot of forms to fill out to be 'covered' by the hospital and for legal reasons. Stupid to hold us up, yes, necessary, unfortunately.
4. You can volunteer in some places as an HCA/admin which would help immensely, I imagine.

I do agree, I think we should be being utilised in some way, but there's a definite voice for the opposite as well; many students don't feel ready and feel out of their depth and at risk.
Reply 2
Original post by Don'tMessThisUp
So
1. Graduation is up to your university, and they need to be sure that you've all met your GMC requirements before they send you packing. For some of us, that's about hours spend on the wards, for other it's exams, for others it's competencies, etc.
2. If you were graduated early, that's all you would be. Just graduated. You would be a BMBS, but you would not be on the register - that's the most important thing to note. You're not a legally allowed to practice doctor until you're on the medical register. The register has nothing to do with the university, the GMC makes the decisions about when they're registering you. They've said they're not doing it early yet, which I imagine has more to do with needing to thoroughly check that all the unis who did finals in final year have met the required standards.
3. We're all starting new jobs; we'll need inductions, to move, to get settled, get passwords etc. That's not really going to happen right now. So we could start our doctoring jobs in our current deaneries, but I imagine there are also a lot of forms to fill out to be 'covered' by the hospital and for legal reasons. Stupid to hold us up, yes, necessary, unfortunately.
4. You can volunteer in some places as an HCA/admin which would help immensely, I imagine.

I do agree, I think we should be being utilised in some way, but there's a definite voice for the opposite as well; many students don't feel ready and feel out of their depth and at risk.

1. There will be no further teaching or placement at my university until the end of the academic year anyway, so if they can graduate us then, they can graduate us now.
2. I know, but again, if the GMC can register us (the ones that have taken finals and have no further teaching/placement) in July, they might as well register us now.
3. I agree. I doubt the situation will be much better in August though, especially if "suppression" measures are working, as this will prolong the current situation. Induction could be cut short to maybe just a few days. Not ideal, I know, but surely made up by the fact that that hospital will have dozens of more doctors.
4. Our university explicitly asked us not to volunteer or take up any contracts in the NHS until there is some sort of national guidance on that (presumably from the GMC?).
Original post by Anonymous
1. There will be no further teaching or placement at my university until the end of the academic year anyway, so if they can graduate us then, they can graduate us now.
2. I know, but again, if the GMC can register us (the ones that have taken finals and have no further teaching/placement) in July, they might as well register us now.
3. I agree. I doubt the situation will be much better in August though, especially if "suppression" measures are working, as this will prolong the current situation. Induction could be cut short to maybe just a few days. Not ideal, I know, but surely made up by the fact that that hospital will have dozens of more doctors.
4. Our university explicitly asked us not to volunteer or take up any contracts in the NHS until there is some sort of national guidance on that (presumably from the GMC?).

1. Fine, you can graduate. You are now no longer a student (so get ready to pay all the extra stuff, council tax, etc) and you aren't a registered doctor, so get ready to um... sit on your ass.
2. They could, yes, but they've explicitly said they're not looking at that at this junction, and while we're med students, we don't work for the GMC and don't know the precise reasoning for this, which could be to do with advice from the hospitals themselves, who may not want thousands of new doctors being set loose at this junction without overseeing. It's unsafe practice.
3. Induction will absolutely not be cut short, you might be sure of your skills, but the hospitals are not. Have you not met some of the useless F1s? There are people who have graduated out of their med schools who were so not ready for that job, I doubt the GMC and the hospitals are going to be happy to hand over care to them. And no, dozens of **** doctors is not better than no doctors. First, Do No Harm.
4. Oh, that's odd; we've been offered HCA and admin roles and filled out a form about volunteering, so i guess it depends on where you are. So I guess just listen to your uni for now?
Reply 4
Original post by Don'tMessThisUp
1. Fine, you can graduate. You are now no longer a student (so get ready to pay all the extra stuff, council tax, etc) and you aren't a registered doctor, so get ready to um... sit on your ass.
2. They could, yes, but they've explicitly said they're not looking at that at this junction, and while we're med students, we don't work for the GMC and don't know the precise reasoning for this, which could be to do with advice from the hospitals themselves, who may not want thousands of new doctors being set loose at this junction without overseeing. It's unsafe practice.
3. Induction will absolutely not be cut short, you might be sure of your skills, but the hospitals are not. Have you not met some of the useless F1s? There are people who have graduated out of their med schools who were so not ready for that job, I doubt the GMC and the hospitals are going to be happy to hand over care to them. And no, dozens of **** doctors is not better than no doctors. First, Do No Harm.
4. Oh, that's odd; we've been offered HCA and admin roles and filled out a form about volunteering, so i guess it depends on where you are. So I guess just listen to your uni for now?

1. Of course I wouldn’t want them to graduate us and then at the same time not register us early. The whole reason why I started this thread is because I don’t want to sit on my ass.
2. I appreciate that it would be a difficult time for us to start working. But it’s very unlikely that the situation in August will be better than what it is now. And if anything our skills and knowledge will be somewhat decreased by then.
3. I’m pretty sure that if medical schools are able to cancel OSCEs or apprenticeship placements in final year, hospitals will also be able to shorten induction periods (different trusts have different lengths of that anyway, and it’s not like the ones that only do a few days are less safe than the ones doing 10 days). Of course there are some useless F1s and I would also have some anxieties about starting early. But most of us (at least the ones who did all their finals) are basically doctors now. There’s not going to be a magical switch that will make us be or feel more competent between now and August.
4. Yeah seems a shame they haven’t been able to be consistent with that across medical schools.

Look, I really appreciate your thoughts on this. I guess my main point is this: I believe I would be better equipped to start working now than after having done nothing for 4 months. But i can also understand that hospitals might not want lots of new F1 right now (question is though whether that’s going to be different by the end of July). And I also have the luxury of not being in an at risk group or living with elderly family members. I would probably be way more apprehensive about starting early if that was the case.

Would be interested to hear what current F1s think about this!
Original post by Anonymous
Look, I really appreciate your thoughts on this. I guess my main point is this: I believe I would be better equipped to start working now than after having done nothing for 4 months.

Yeah I agree you would be. I think in terms of raw medical knowledge, the peak of your whole career is just after finals.

You'd also be starting in a familiar region, which will help a lot.

But i can also understand that hospitals might not want lots of new F1 right now (question is though whether that’s going to be different by the end of July).


That's the thing - what would you practically be doing? Fulfilling the role of a full doctor? Because at least in the first week, that does take a lot of supervision from seniors who may be too busy... or they might rather have you anyway? Although if you're there nailing the bloods, cannulas, ABGs, you'd definitely be super useful... so why not just be a phlebotomist or HCA? Or maybe we should save that role for more junior med students?

Honestly, don't know the answer to the above. Its great that you feel ready for whatever comes though!
Reply 6
Original post by nexttime
That's the thing - what would you practically be doing? Fulfilling the role of a full doctor? Because at least in the first week, that does take a lot of supervision from seniors who may be too busy... or they might rather have you anyway? Although if you're there nailing the bloods, cannulas, ABGs, you'd definitely be super useful... so why not just be a phlebotomist or HCA? Or maybe we should save that role for more junior med students?


Writing ward round notes, ordering investigations, doing simple referrals, drafting EDNs, doing bloods, cannulas, ABGs. Of course that will need some supervision, especially in the first week or so. But it’s not like we have never done these things on placements before. Do I think I would nail every cannula? No of course not, but if I have a week of doing loads then I will get better and start being of help quite quickly I would hope.
Original post by Anonymous
My school has cancelled all our remaining placements and we already sat our finals two months ago. Why can't they graduate and register us early? Surely, I'm going to be a better doctor now and can be of more use even if it's just to free-up more senior doctors from basic ward work, than if I sat around until August without any further placements or teaching.



Perhaps those people in charge of administering an entire nation of doctors, and the people coordinating this crisis at the highest level, have paused to ponder this question and taken a decision based on having access to all the information and pros/cons.
Reply 8
Original post by Anonymous
Perhaps those people in charge of administering an entire nation of doctors, and the people coordinating this crisis at the highest level, have paused to ponder this question and taken a decision based on having access to all the information and pros/cons.

Thanks. By that argument no one would be allowed to question the government's strategy because they are "people coordinating this crisis at the highest level [...] having access to all the information and pros/cons".

I was interested in what other students and doctors would say about this, not in being told that I can't ask that question because the people in charge would know best anyway.
Original post by Anonymous
Writing ward round notes, ordering investigations, doing simple referrals, drafting EDNs, doing bloods, cannulas, ABGs. Of course that will need some supervision, especially in the first week or so. But it’s not like we have never done these things on placements before. Do I think I would nail every cannula? No of course not, but if I have a week of doing loads then I will get better and start being of help quite quickly I would hope.


Yeah I agree I think you would be useful. just trying to work out what specific role it would be in.

I think a key reason why I think they should get you guys in and do it early is that I am genuinely worried about some of my older colleagues - I think they might actually die. Whereas you guys... I'll state with confidence that you will be fine. Under such circumstances, that is important!
NI is supposedly provisionally registering QUB final year students 4 months early, which would be next month. It's part of the Health Minister's surge plans:

https://www.health-ni.gov.uk/news/covid-19-surge-plans-detailed-assembly

I know the GMC says we currently aren't the plan but I'm sure that we are a back up plan at least. They're probably waiting to see how many previously retired doctors will re-register but as scary as it would be to start early I do think we would be a better bet than doctors who's age put them most at risk of corona virus. We are the group that's less likely to suffer ill effect of corona virus or even to display symptoms of it at all.

I do think we'll be called in early at some stage and I would rather it be earlier than later so there's still the staffing for us to have supervision and help for the first couple of weeks than to drop us in when the **** hits the fire and half the workforce is out.
Original post by Anonymous
NI is supposedly provisionally registering QUB final year students 4 months early, which would be next month. It's part of the Health Minister's surge plans:

https://www.health-ni.gov.uk/news/covid-19-surge-plans-detailed-assembly

I know the GMC says we currently aren't the plan but I'm sure that we are a back up plan at least. They're probably waiting to see how many previously retired doctors will re-register but as scary as it would be to start early I do think we would be a better bet than doctors who's age put them most at risk of corona virus. We are the group that's less likely to suffer ill effect of corona virus or even to display symptoms of it at all.

I do think we'll be called in early at some stage and I would rather it be earlier than later so there's still the staffing for us to have supervision and help for the first couple of weeks than to drop us in when the **** hits the fire and half the workforce is out.

I think it's the opposite. They're keeping us 'clean' and away from the hospital. Come August, the situation will be very different and having another 7000 docs may actually be some use.

As it is, sending all our new recruits into a chemical war zone might not be the best plan? Ultimately we are right at the bottom of the pile and as clever as you want to say we are, they have a responsibility to supervise us. Even those who can do, can't do until proven to do so. At the moment it simply may be that having new people about is going to be too taxing on the system, on the staff. If they ask for us (and not ventilators), then we're here. But I haven't heard any voices from the hospitals saying anything other than 'PPE and equipment'. No one is asking for us? They went to the retired docs first because knowledge, experience are more useful in this situation, and us acting (or being) doctors is not going to suddenly endow us with that knowledge.

Absolutely, they should put us to use; but I think they should just re-instate placement as is, on a case-to-case basis regarding risk (maybe no ICU placements), where we can do more than we could do as an HCA, and the staff feel more confident in how we can help, or alternatively telling us to sod off if we're not needed/hindering.
Original post by Don'tMessThisUp
I think it's the opposite. They're keeping us 'clean' and away from the hospital. Come August, the situation will be very different and having another 7000 docs may actually be some use.

As it is, sending all our new recruits into a chemical war zone might not be the best plan? Ultimately we are right at the bottom of the pile and as clever as you want to say we are, they have a responsibility to supervise us. Even those who can do, can't do until proven to do so. At the moment it simply may be that having new people about is going to be too taxing on the system, on the staff. If they ask for us (and not ventilators), then we're here. But I haven't heard any voices from the hospitals saying anything other than 'PPE and equipment'. No one is asking for us? They went to the retired docs first because knowledge, experience are more useful in this situation, and us acting (or being) doctors is not going to suddenly endow us with that knowledge.

Absolutely, they should put us to use; but I think they should just re-instate placement as is, on a case-to-case basis regarding risk (maybe no ICU placements), where we can do more than we could do as an HCA, and the staff feel more confident in how we can help, or alternatively telling us to sod off if we're not needed/hindering.


I think you may have misread my post as I don't think I've said anywhere that we are so extraordinarily clever? Obviously any retired consultant is going to know way more than us in their speciality. The one small point being that they are generally over 65 and fall into the highest risk category in terms of age.

I merely posted to point out that NHS NI contrary to what the GMC has said is aiming to provisionally register final year medical students and the NI health minister has been saying so since last week. Therefore, I don't think the GMC's 'currently we are not the plan' can be taken as concrete. The plan may change depending on how many doctors return, if we're unable to flatten the curve or if devolved health ministers decide that that's the best way to bolster staffing.

And if there is plan or there comes to be a plan where we are to be provisionally registered early I, personally, would like that to happen before we hit the peak so that we can get the supervision we need and some sort of induction. Starting F1 is always extremely scary and to be starting in the middle of a pandemic is terrifying!
Original post by Anonymous
I think you may have misread my post as I don't think I've said anywhere that we are so extraordinarily clever? Obviously any retired consultant is going to know way more than us in their speciality. The one small point being that they are generally over 65 and fall into the highest risk category in terms of age.

I merely posted to point out that NHS NI contrary to what the GMC has said is aiming to provisionally register final year medical students and the NI health minister has been saying so since last week. Therefore, I don't think the GMC's 'currently we are not the plan' can be taken as concrete. The plan may change depending on how many doctors return, if we're unable to flatten the curve or if devolved health ministers decide that that's the best way to bolster staffing.

And if there is plan or there comes to be a plan where we are to be provisionally registered early I, personally, would like that to happen before we hit the peak so that we can get the supervision we need and some sort of induction. Starting F1 is always extremely scary and to be starting in the middle of a pandemic is terrifying!


Interesting, didn't know about the situation in Northern Ireland.

Yeah I agree, I think the fact that we have a significantly lower risk is quite important in this.
Warwick University is asking all final year students to start work full time on Monday
Original post by Anonymous
Warwick University is asking all final year students to start work full time on Monday

In what capacity do you know?
Original post by Anonymous
In what capacity do you know?

Job title will be final year medical student still but you'll be paid band 4. We won't be registered yet so will need to get prescriptions signed off but can do everything else as long as competent.
Our medical school has not told us anything about this. Has anyone been told anything by theirs?
Only found out an hour ago and I get the feeling that most med schools found out with us
I think a key point on the question of early registration is how likely it is you think the NHS will need an extra 5000 doctors in the near future. I can't speak for other people's hospitals but ours is certainly quite than usual at this exact moment - we absolutely aren't required as Doctors right this second.

The thing is - inducting us and supervising us right now is probably fairly manageable (we do it every year in August anyway), but inducting us and doing that initial supervision will be hell / impossible in the not very distant future.

It's complex - but I think it hugely unlikely that we're all going to be left at home and not registered until August. Don't forget they moved the STEP form deadline forwards by several months - it now matches up with the day we all get our jobs...

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