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    (Original post by MagicNMedicine)
    They should have done a proper degree, if they'd done Economics or Law they would be able to avoid the gravy train of a dead end job
    lol
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    Remedy UK think there's a long-term agenda of having a sub-consultant grade, with the golden ladder to the full job closed off to most.
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    (Original post by Helenia)
    Basically, assuming you want to be a consultant (we'll exclude GPs from the equation to avoid confusion) in the end, you need to get a run-through training post, which will last 5-8 years (depending on specialty) and at the end you will get a Certificate of Completion of Specialist Training (CCST) which entitles you to apply for consultant posts.

    If you DON'T get a run-through job, you usually get what used to be called "staff grade" or "trust grade" jobs. They usually work either at senior SHO or registrar level (i.e. middle grade), so have a reasonable amount of responsibility, and if they're in surgery can operate by themselves for simple cases depending on their experience, but as they don't have a training post, they are not making progress towards a CCST. They also tend to be less well-paid than training grades. It IS possible to build up a career portfolio and get out of this and onto a training job, but it's hard. They're trying to make it easier to get back on the training ladder/harder to get stuck off it, but it is still far from guaranteed that you'll get a post that will lead you right through up to consultant level. I presume there are some people who like it - there are quite a lot in A&E for example, who get to do lots of "fun" stuff all day but without the paperwork and tedium (and £££) of being a consultant.
    How do they decide who gets the run through training and who doesn't? What if you want to be a GP?
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    (Original post by Helenia)
    Basically, assuming you want to be a consultant (we'll exclude GPs from the equation to avoid confusion) in the end, you need to get a run-through training post, which will last 5-8 years (depending on specialty) and at the end you will get a Certificate of Completion of Specialist Training (CCST) which entitles you to apply for consultant posts.

    If you DON'T get a run-through job, you usually get what used to be called "staff grade" or "trust grade" jobs. They usually work either at senior SHO or registrar level (i.e. middle grade), so have a reasonable amount of responsibility, and if they're in surgery can operate by themselves for simple cases depending on their experience, but as they don't have a training post, they are not making progress towards a CCST. They also tend to be less well-paid than training grades. It IS possible to build up a career portfolio and get out of this and onto a training job, but it's hard. They're trying to make it easier to get back on the training ladder/harder to get stuck off it, but it is still far from guaranteed that you'll get a post that will lead you right through up to consultant level. I presume there are some people who like it - there are quite a lot in A&E for example, who get to do lots of "fun" stuff all day but without the paperwork and tedium (and £££) of being a consultant.
    But, I'm assuming that a fresh FY2 doesn't have any kind of advantage over a staff grade, if anything surely the opposite is true? They have more experience and have been doing it longer. So surely they'd have a better portfolio than the FY2 person.

    So surely it must be easier to get a position after, rather than soon? Sort of like a gapper getting life experience before applying to university.

    Or am I missing something here?
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    (Original post by Barny)
    How do they decide who gets the run through training and who doesn't? What if you want to be a GP?
    Same as for any job - you fill in a form/send off your CV and apply. They pick people they like the look of best.

    GP training works in a similar way, but AFAIK there are not staff grade positions in GPland, so if you get on the scheme you should be a GP at the end (though getting a partnership is becoming harder and harder)

    (Original post by RollerBall)
    But, I'm assuming that a fresh FY2 doesn't have any kind of advantage over a staff grade, if anything surely the opposite is true? They have more experience and have been doing it longer. So surely they'd have a better portfolio than the FY2 person.

    So surely it must be easier to get a position after, rather than soon? Sort of like a gapper getting life experience before applying to university.

    Or am I missing something here?
    Weeelll...yes and no. Will explain more later but have to go to work! :o:
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    (Original post by Helenia)
    Same as for any job - you fill in a form/send off your CV and apply. They pick people they like the look of best.

    GP training works in a similar way, but AFAIK there are not staff grade positions in GPland, so if you get on the scheme you should be a GP at the end (though getting a partnership is becoming harder and harder)


    Weeelll...yes and no. Will explain more later but have to go to work! :o:
    I shall await your reply :P
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    (Original post by RollerBall)
    But, I'm assuming that a fresh FY2 doesn't have any kind of advantage over a staff grade, if anything surely the opposite is true? They have more experience and have been doing it longer. So surely they'd have a better portfolio than the FY2 person.

    So surely it must be easier to get a position after, rather than soon? Sort of like a gapper getting life experience before applying to university.

    Or am I missing something here?
    Well, I'm no expert, haven't even applied for MTAS yet, but here's my take on things:
    F2s may be less experienced, but they are in the right place career-wise. It is better (in the eyes of MTAS) to be in training jobs the whole time and not lose momentum. Plus they are newer and shinier and haven't (hopefully) developed too many bad habits yet. Staff grades may gradually build up their portfolios, and can get back onto the training ladder, but there's a stigma to being in a staff grade job, and it will make people think "Why weren't they good enough to get a training post first time?"
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    The "person specifications" for CT\ST jobs often have a maximum previous experience in that specialty. MTAS was in part geared to shortening training, picking the people it thinks cut it first time round and sticking with them.
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    I've heard in the mess that you had a maximum of one year locum/staff grading before you cut yourself out of ST. This was from back when MTAS was really really kicking off, so it might be different now but its consistent with what I've heard elsewhere. Or it might be one of those in-effect things rather than an absolute written rule.
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    Well I must say, what an absolutly awful system. With stiff competition for a speciality do they expect you to go into a speciality you feel you are unsuited to for the rest of your life or be stuck at a staff grade?

    I'm all for speeding up training, but not to the extent where it's a "cut your losses" mentality and if you're not good enough first time, they can't be assed with you. What sort of mentality is that?
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    Good post on the MMC ****-up here, worth a read:

    http://thejuniordoctor.blogspot.com/...l-careers.html

    The old system meant that people could spend a very long time at SHO level, with uncertain prospects of ever getting onto the golden ladder. The average age of getting a consultant job was quite a bit older than is intended under the new system. There was a government desire to get extra consultants onto the books ASAP, which meant effectively shortening training. So rather than have those SHOs hanging around accumulating experience in the hope of bagging a registrar job later on, they're being told early on that they'll probably never make it, at least not via the traditional route. People have always had to compromise on their choice of specialty though - there just aren't that many plastic surgery jobs that need filling.

    The optimistic view is that with the shortening of working hours, having a reserve of people qualified to F2/CT2 level (depending on when they fall off the ladder) will actually be seen as a useful resource, so staff grade jobs will be made more appealing and lose some of their current stigma. People will accept losing the prospect of a nice income as a consultant in return for predictable, relatively family-hours, etc. And obtaining CCT by the alternative route will be seen as just as good. Hear this version from the MMC website.

    The pessimistic view is that consultants in the future simply won't have the vast hours of experience of their predecessors, and won't have the same confidence in their decision-making. So most will end up functioning at a registrar-plus\sub-consultant level, at a decent salary but not as much as in the past and without as good a pension entitlement. There will still be progression to the top of the tree for some, but not all, the prospect of which keeps them interested. So in fact moving up that lost generation of not-quite-registrars to being not-quite-consultants. Remedy UK offer predictions of this version.
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    (Original post by RollerBall)
    Well I must say, what an absolutly awful system. With stiff competition for a speciality do they expect you to go into a speciality you feel you are unsuited to for the rest of your life or be stuck at a staff grade?

    I'm all for speeding up training, but not to the extent where it's a "cut your losses" mentality and if you're not good enough first time, they can't be assed with you. What sort of mentality is that?
    The MMC mentality. I agree, it forces you to choose specialties very early, which is not ideal for many people. You will apply for specialty training in ~December of your F2 year, so you've had under 18 months of being a doctor, will have done a maximum of 5 specialties (if you do 4 in your F1 year as I am, but that's not very common) quite possibly not even including the one you're interested in. If you decide you've picked the wrong specialty want to change, it will a)be more difficult and b)mean taking a significant pay cut.

    Huw Davies' post says everything else that I would have said, so I shan't repeat it!
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    Christ, this has made me uncertain about my decision to enter medicine now.
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    I'd go for the army if I couldnt get one in the NHS.
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    (Original post by AAAirz)
    I'd go for the army if I couldnt get one in the NHS.
    If the army wanted you...
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    (Original post by Renal)
    If the army wanted you...
    No.

    I'd have a go at applying to become a doctor in the army if I couldn't get a job in the NHS. I wouldn't know whether they wanted me until I got an offer or rejection.

    Since were being pedantic, this is all provided I get accepted and indeed finish medical school.
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    (Original post by RollerBall)
    Christ, this has made me uncertain about my decision to enter medicine now.
    Hey man, at least I clued you up to it now and it won't come as a massive shock if and when you get to that stage. Just make sure you're not one of those on-the-lash-3-times-a-week losers at Uni and actually get some work and society experience and you might be ok.
 
 
 
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