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Funding medical degrees when 25% of junior doctors quit within 1 year Watch

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    (Original post by tomheppy)
    What fundamental errors have I made and why is it a warped view?
    Sigh.. I see you reeling me in, but fine, I'll bite.

    (Original post by tomheppy)
    Government shouldn't be funding medical education. Let medics pay for it themselves.
    This part is just bonkers for a start. Why on earth should medics have to pay £250,000 in order to spend the rest of their working lives serving the public?

    (Original post by tomheppy)
    Why the hell should the taxpayer pay for their education AND their enormous salaries?
    Doctors hardly have enormous salaries, especially taking into account the time they work, the debt they already incur, the costs they have to go through (e.g. insurance, GMC registration, postgraduate exam fees) and the lengthy time it takes to start earning the salaries often cited in the media. Junior doctors currently work criminal and antisocial hours for the pay of a waiter.

    Secondly, the taxpayer should pay for their salaries, well, erm, because they work in the public sector? :dontknow:

    (Original post by tomheppy)
    Doctors have a very good reason for supporting the current system which limits medical education which is that they limit competition with other doctors and so drive their prices up.
    Prices? What prices are you talking about? The patient doesn't receive a bill at the end of their treatment (outside of the standardised prescription charges, for example). Medicine in the UK is not a free market.

    There you go, I took your trolling bait. Hit me with some circular arguments.
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    [QUOTE=GodspeedGehenna;28709287]
    Doctors hardly have enormous salaries, especially taking into account the time they work, the debt they already incur, the costs they have to go through (e.g. insurance, GMC registration, postgraduate exam fees) and the lengthy time it takes to start earning the salaries often cited in the media. Junior doctors currently work criminal and antisocial hours for the pay of a waiter.
    While I appreciate and fully agree with your point, that level of hyperbole detracts from your point. Even as an FY1, your base salary is equal to the median salary of the UK, and you get even higher with banding...

    (I know that didn't really add anything, but I find that FY1s are a bit guilty of sob story whoring. I know it's a hard job, I see the hours my brother works, but still...)
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    (Original post by Organ)
    Medicine costs around £250K per person - you can't expect people to pay that amount of money and retain the British salaries for doctors. The 23% is for after F2 I believe. Modernising Medical Careers has a lot to do with it, I doubt this many left before MMC was introduced.

    Regards the 23% - Majority of these are people who take a gap year/work overseas for a year. Some pursue research jobs which are classed as "non-training". Some people are overseas students who having trained in UK and completed foundation programme want to go "home". Increasing numbers are on maternity leave, starting family etc. at this point in their career. So the numbers packing up and leaving altogether is rather low.



    NO THEY DON'T.

    Why make these threads if you don't appreciate the basics! Nobody employs junior doctors in private practice, and the over-over-whelming number of consultants in private practice spend the majority of their time in the NHS. Only in the unique cases of people like Harley St. doctors are they purely private. Jeez!



    But decisions about the numbers of doctors has to be made years in advance. And the funding and so on has to be available, the infrastructure to cope with new doctors yada yada hs to be planned.



    Numbers have increased in recent year - with the enlargement of existing medical schools and the opening of new schools - HYMS, Warwick and so on.

    It's odd that of all the courses to take a stick to you pick medicine :curious:
    I didn't mean enter private practice immediately! I meant over their career. Please don't assume I know nothing about medicine, I very nearly applied for it at uni.

    And neither was I advocating creating more places suddenly - I'm just saying that there were few possible ways to solve the problem and that was one of them, although not one I believe is feasible.
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    (Original post by innerhollow)

    While I appreciate and fully agree with your point, that level of hyperbole detracts from your point. Even as an FY1, your base salary is equal to the median salary of the UK, and you get even higher with banding...

    (I know that didn't really add anything, but I find that FY1s are a bit guilty of sob story whoring. I know it's a hard job, I see the hours my brother works, but still...)
    I think F1 doctors and in fact most doctors in their first few years have many right to complain.

    They firstly have little control over where they work. It's all based on what appears to be a lottery, mostly decided by how they answer a few questions and not on their ability as a doctors. They have to rank areas of the country and then are assigned one based on how many points they got from their questions and other factors. They could end up the other side of the country from where they want to be and face a choice of not being a doctor or moving there. Most then face a similar situation with the area they are allocated and could end up in the wrong town or city from where they need to be - doesn't really matter if you have a partner or family somewhere.

    Next they often have to move jobs every 3-4 months. They might be lucky and have some in the same hospital durin the first year and during the second year, but in nearly every case they will be in different hospitals in the first and second years and that means being in different towns in most parts of the country. After the second year it's a whole new application process and they could end up somewhere totally different. There is little control over where they work and they seem to have no ability to settle down anywhere for years. They don't know if they will be able to stay anywhere for more than a year or two.

    Then there are the working hours...if they work their allotted time, then most will just be at the limited of hours they are leally able to work. Very few jobs are at this level of hours already. However, many will work more than this as they cannot leave the hospital when their shift ends if they are still seeing patients. They can't say they'll leave that patient to die as they have to go home. Instead they work over their time doing more hours than are legally allowed.

    You might think the above situation doesn't happen. But it does. Right from the start junior doctors in their first year are sometimes left as the main doctor the cover some very sick patients. They may have people they can call in to help out, but in emergencies they can be the first and only doctor to see the patient and are responsible for that patient. New doctors are thrown in at the deep end with very high responsibility from the start and they are expected to just get on with it.

    You also have the poor working hours, where someone could work a 13 hour shift on Friday, be back at work 8 hours later for another 13 hour shift Saturday and another on Sunday before being back in at 8:30am on the Monday. No weekend at all for them. Others have to work nights or sometimes 13 hour shifts during the week. It can be quite anit-social at times. Any doctor having normal hours should feel lucky.

    Then there is the holiday time - in quite a number of jobs I'm told it's decided for you when it is. You might also be required to work Christmas and New Year - if you're down to work those times, good luck finding someone to swap it with you.


    And as well as working they are expected to practice procedures to show their progress, be reviewed, possibly carry out research if they have time, pay for registration to be allowed to work as a doctor, pay several hundred pounds to sit exams to be allowed to continue in to the next part of their training and know there are not enough places in that training for everyone at their level, so they might not even get in.


    I'm sure there's loads more that could be said. From what I've seen the life as a newly qualified doctor is not good and it's not easy. But they are dedicated to their job and get on and do it, performing one of the most important public serving jobs we have. We need to ensure we support these people as we rely on them so much. They actually won't fight for themselves enough in my opinion, they just get on and do the job. They won't strike, like the London Tube drivers do all the time. Yet junior doctors are paid less than a tube driver and have much worse working conditions and hours.

    So let's not even consider making these guys pay even more for their degree. We'd be lost without them as a society and we'd simply attract the wrong people if we price the best out of it.
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    (Original post by RK)
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    Quotes have gone funny. Looks like you've quoted another poster but it has put my name.
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    (Original post by RK)
    I think F1 doctors and in fact most doctors in their first few years have many right to complain....
    I come from a family of doctors, my brother's currently working as an FY1, believe me everything you've said I've heard it MANY, MANY times before.

    There are also many rewards to being an FY1, you enjoy very high graduate salaries (you may not think FY1s earn a lot, but it's far more than your average graduate), a guaranteed job after employment, thus exempting you from the horrors of job-searching and unemployment; a good career trajectory in the NHS or (eventually) private practice here or abroad; and of course a rather high job security.

    Of course the working hours are long and hard, but that's one of the stipulations of the job whatever level you are at. I agree that it's a hard job, I wasn't disputing that, but it's not like other graduates are having an easy time of it. They face their own struggles:

    - Other graduates also have to put up with also being put in the deep end for many tasks too without much help and face lots of stress
    - Worries about their future career and job security
    - Needing to move to different areas just to find a job (forget questionnaries and ranking your favourite areas- you move to wherever a company is willing to hire you)
    - Struggling with the job search and long, soul-destroying periods of unemployment
    - Needing to put in long hours to complete tasks for projects or assigned work- it is most definitely not just doctors who work extra unpaid hours and anti-social hours
    - This constant need to prove themselves in order to develop good CV material for moving to future jobs of which you have no certainty.

    I am not suggesting that we make medics pay more for their degrees by the way (my point wasn't directly related to the thread title) nor am I suggesting that it isn't a very difficult job being a junior doctor. My point is just that any career, particularly at the start, has its difficulties.
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    (Original post by RK)

    I think F1 doctors and in fact most doctors in their first few years have many right to complain.

    They firstly have little control over where they work. It's all based on what appears to be a lottery, mostly decided by how they answer a few questions and not on their ability as a doctors. They have to rank areas of the country and then are assigned one based on how many points they got from their questions and other factors. They could end up the other side of the country from where they want to be and face a choice of not being a doctor or moving there. Most then face a similar situation with the area they are allocated and could end up in the wrong town or city from where they need to be - doesn't really matter if you have a partner or family somewhere.

    Next they often have to move jobs every 3-4 months. They might be lucky and have some in the same hospital durin the first year and during the second year, but in nearly every case they will be in different hospitals in the first and second years and that means being in different towns in most parts of the country. After the second year it's a whole new application process and they could end up somewhere totally different. There is little control over where they work and they seem to have no ability to settle down anywhere for years. They don't know if they will be able to stay anywhere for more than a year or two.

    Then there are the working hours...if they work their allotted time, then most will just be at the limited of hours they are leally able to work. Very few jobs are at this level of hours already. However, many will work more than this as they cannot leave the hospital when their shift ends if they are still seeing patients. They can't say they'll leave that patient to die as they have to go home. Instead they work over their time doing more hours than are legally allowed.

    You might think the above situation doesn't happen. But it does. Right from the start junior doctors in their first year are sometimes left as the main doctor the cover some very sick patients. They may have people they can call in to help out, but in emergencies they can be the first and only doctor to see the patient and are responsible for that patient. New doctors are thrown in at the deep end with very high responsibility from the start and they are expected to just get on with it.

    You also have the poor working hours, where someone could work a 13 hour shift on Friday, be back at work 8 hours later for another 13 hour shift Saturday and another on Sunday before being back in at 8:30am on the Monday. No weekend at all for them. Others have to work nights or sometimes 13 hour shifts during the week. It can be quite anit-social at times. Any doctor having normal hours should feel lucky.

    Then there is the holiday time - in quite a number of jobs I'm told it's decided for you when it is. You might also be required to work Christmas and New Year - if you're down to work those times, good luck finding someone to swap it with you.


    And as well as working they are expected to practice procedures to show their progress, be reviewed, possibly carry out research if they have time, pay for registration to be allowed to work as a doctor, pay several hundred pounds to sit exams to be allowed to continue in to the next part of their training and know there are not enough places in that training for everyone at their level, so they might not even get in.


    I'm sure there's loads more that could be said. From what I've seen the life as a newly qualified doctor is not good and it's not easy. But they are dedicated to their job and get on and do it, performing one of the most important public serving jobs we have. We need to ensure we support these people as we rely on them so much. They actually won't fight for themselves enough in my opinion, they just get on and do the job. They won't strike, like the London Tube drivers do all the time. Yet junior doctors are paid less than a tube driver and have much worse working conditions and hours.

    So let's not even consider making these guys pay even more for their degree. We'd be lost without them as a society and we'd simply attract the wrong people if we price the best out of it.
    I have to say that in emergencies a doctor in their first 2 years (F1 or F2) will never be the only person to see the patient. I think it is important that this point in particulat is corrected.

    Honestly it isn't as bad as all that. Geographically things can be difficult but junior doctors are based within a region and things are reasonably flexible. There are always 1 or 2 people who are unfortunate but that is the same in every professional career. The applications process isn't perfect but given that it was junior doctors and medical students who actively campaigned for a national scheme it is comparable to UCAS in its "fairness".

    Doctors are not the only profession who work long and anti-social hours. Neither are they the only profession (either public or private sector) who work extra hours for no immediate financial reward. Pre-arranged annual leave occurs in a significant minority of jobs and is not something I agree with but again there is flexibility for swopping within that. Of course, a minority of junior doctors have to work on Christmas day and New Years Day - less than the nursing staff, paramedics, hospitality industry staff etc..

    Professional exams and fees are not unique to medicine. Yes they are bloody annoying but on balance a necessary evil.

    Life as a junior doctor is not bad. It is often good fun. Sure it is hard work - but the pay packet at the end of each month is decent.
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    (Original post by angelmxxx)
    I didn't mean enter private practice immediately! I meant over their career. Please don't assume I know nothing about medicine, I very nearly applied for it at uni.

    And neither was I advocating creating more places suddenly - I'm just saying that there were few possible ways to solve the problem and that was one of them, although not one I believe is feasible.
    Hahahahahahaha

    I'm a medical student and my understanding of the intricacies of the medical system is basic to say the least.

    I also very nearly applied to be an astronaut! Send me to the moon?

    Joker
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    (Original post by Ataloss)
    I have to say that in emergencies a doctor in their first 2 years (F1 or F2) will never be the only person to see the patient. I think it is important that this point in particulat is corrected.
    Maybe we're disagreeing on what being the only doctor means, but believe me, unless you're talking about there being another doctor somewhere in a big hospital with different responsibilities or one at the end of a phone line at home, you're incorrect in what you're saying. Maybe what you're saying is how it should be, but it doesn't seem to work like that in practice.

    Honestly it isn't as bad as all that. Geographically things can be difficult but junior doctors are based within a region and things are reasonably flexible. There are always 1 or 2 people who are unfortunate but that is the same in every professional career. The applications process isn't perfect but given that it was junior doctors and medical students who actively campaigned for a national scheme it is comparable to UCAS in its "fairness".
    I was actually quite horrified by how poorly medical students were treated in their application process. Yes it could be much worse and maybe you don't think it's too bad, but it does cause a lot of stress and headaches for people in the process. Most just put up with it though. It's a shame really. We should be treating our new doctors better than this.

    Doctors are not the only profession who work long and anti-social hours. Neither are they the only profession (either public or private sector) who work extra hours for no immediate financial reward. Pre-arranged annual leave occurs in a significant minority of jobs and is not something I agree with but again there is flexibility for swopping within that. Of course, a minority of junior doctors have to work on Christmas day and New Years Day - less than the nursing staff, paramedics, hospitality industry staff etc..

    Professional exams and fees are not unique to medicine. Yes they are bloody annoying but on balance a necessary evil.
    Life as a junior doctor is not bad. It is often good fun. Sure it is hard work - but the pay packet at the end of each month is decent.
    It may well be good fun for many, but really what I was getting at is that things are also quite tough in many ways and we shouldn't be purposefully trying to make it more difficult, either for entry in to medicine or for the doctors once they are working. To do so would start to turn people off from medicine and mean we don't have the best and most committed people in the jobs
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    shut up we need more places its too hard
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    (Original post by RK)
    Maybe we're disagreeing on what being the only doctor means, but believe me, unless you're talking about there being another doctor somewhere in a big hospital with different responsibilities or one at the end of a phone line at home, you're incorrect in what you're saying. Maybe what you're saying is how it should be, but it doesn't seem to work like that in practice.
    It is simply wrong to suggest that a doctor in their first 2 years (F1 or F2) will be the only doctor left to deal with an emergency or critically ill patient on their own. They may be the first point of contact and have to escalate the situation but they are never on their own.

    Of course, F1s and F2s are expected to manage to certain situations on their own but nothing beyond their level of competency.
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    (Original post by Ataloss)
    It is simply wrong to suggest that a doctor in their first 2 years (F1 or F2) will be the only doctor left to deal with an emergency or critically ill patient on their own. They may be the first point of contact and have to escalate the situation but they are never on their own.

    Of course, F1s and F2s are expected to manage to certain situations on their own but nothing beyond their level of competency.
    Again, it may be down to what we interpret as being on their own, but certainly some of the situations I've heard about have been eye-opening and surprising as to how things actually work in hospitals. Your answer seems to go very much 'by the book' of how things should be. Maybe it's even like that in your experience. But how things should be and how things are for ALL people can often be very different.
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    If they stopped funding our education, you'd get medical schools full of idiot rahs who'd quit even earlier and drop out rates would increase. Everyone knows that a lot of rich people go to medical school, don't do very well and quit rather quickly.

    Its the people who are financially strained and know what its like to be in financial pressure; people who actually require the grants who are hard working and will give medicine absolute dedication.
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    (Original post by tomheppy)
    Government shouldn't be funding medical education. Let medics pay for it themselves. Why the hell should the taxpayer pay for their education AND their enormous salaries? Doctors have a very good reason for supporting the current system which limits medical education which is that they limit competition with other doctors and so drive their prices up.
    lol id to see you advocating this when you or your loved ones are ill in a hospital...
    If clever people stopped going into medicine and they wouldn't if it wasn't financially comfortable, then the nation's health would decline.
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    (Original post by RK)
    Again, it may be down to what we interpret as being on their own, but certainly some of the situations I've heard about have been eye-opening and surprising as to how things actually work in hospitals. Your answer seems to go very much 'by the book' of how things should be. Maybe it's even like that in your experience. But how things should be and how things are for ALL people can often be very different.
    Believe me I know how scary things can be in hospitals particularly at night and weekends.

    However, even in smaller hospitals, there are always a minimum of 5 registrar grade doctors actually on site and working (always Emergency Department, Anaesthetic, Obs and Gynae, Paeds and Medical and very often General Surgery etc.) with other registrars and consultants on call from home. In large University hospitals double/treble this.

    Therefore F1 and F2 are never on their own to deal with actual emergencies (as in life or death scenarios).
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    (Original post by Vazzyb)
    If they stopped funding our education, you'd get medical schools full of idiot rahs who'd quit even earlier and drop out rates would increase. Everyone knows that a lot of rich people go to medical school, don't do very well and quit rather quickly.

    Its the people who are financially strained and know what its like to be in financial pressure; people who actually require the grants who are hard working and will give medicine absolute dedication.
    Your post touches upon a valid point (we shouldn't price out motivated but less well-off applicants) but ultimately just ends up being another case of hurling vitriol at rich students. If you want to submit any facts about drop-out rates among different socio-economic groups, that might be somewhat relevant or at the very least would add some credibility to your post. Otherwise please keep your abusive assertions to yourself.

    Honestly I don't know why certain people will denounce snobbery so viciously when they're guilty of the exact same thing, just in inverse.
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    (Original post by tomheppy)
    Mostly due to massive government interference in the healthcare industry (higher gdp per capita spent on health than in the uk)
    And hospitals in USA are mainly ran as businesses, looking to be involved in unscrupulous practice in order to maximise profits that the hospital receives at the end of the year to impress those on the board, it doesn't really seem fair to order additional tests for patients that they don't need just because they their insurance will cover it.



    Most science degrees have much higher costs than the actual tuition fees, should we make it the same for all sciences as is being proposed for medicine? No way, fees which are directly related to the cost of the degree instead of the requirement of people doing that degree for the nation's benefit is a terrible idea, there would be less science graduates which would be disastrous.
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    (Original post by innerhollow)
    Your post touches upon a valid point (we shouldn't price out motivated but less well-off applicants) but ultimately just ends up being another case of hurling vitriol at rich students. If you want to submit any facts about drop-out rates among different socio-economic groups, that might be somewhat relevant or at the very least would add some credibility to your post. Otherwise please keep your abusive assertions to yourself.

    Honestly I don't know why certain people will denounce snobbery so viciously when they're guilty of the exact same thing, just in inverse.
    Because im one of them, I understand the pschye tbh. I don't have any loans, ive always had everything I needed and when I compare myself to students who have things more difficult, they're just so much more motivated than I am. And it is true for other rich kids too. Not everything in life can be proven with statistics im afraid - anecdotes are all there is. Good luck with Cambridge
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    (Original post by Vazzyb)
    Because im one of them, I understand the pschye tbh. I don't have any loans, ive always had everything I needed and when I compare myself to students who have things more difficult, they're just so much more motivated than I am. And it is true for other rich kids too. Not everything in life can be proven with statistics im afraid - anecdotes are all there is.
    Because it doesn't make sense to make such loaded statements as rich kids being inherently worse at education based on mere anecdotes. You say you know some rich kids who, as a result of their privileged upbringing, are less motivated than their less well-off counterparts. I know loads who are more motivated than their counterparts because of parental pressure, the competitive spirit they've had fostered in them, their love of luxury and the ambition they've inherited from their parents.

    Regardless, boths conclusion are based on dubious evidence, and neither are particularly helpful. There will often be statistical differences between people of different social groups (or whatever circumstantial factor you can think of), our priority with education should be to not favour or disfavour ANY particular demographic, based merely on incidental and general differences.
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    (Original post by innerhollow)
    Because it doesn't make sense to make such loaded statements as rich kids being inherently worse at education based on mere anecdotes. You say you know some rich kids who, as a result of their privileged upbringing, are less motivated than their less well-off counterparts. I know loads who are more motivated than their counterparts because of parental pressure, the competitive spirit they've had fostered in them, their love of luxury and the ambition they've inherited from their parents.

    Regardless, boths conclusion are based on dubious evidence, and neither are particularly helpful. There will often be statistical differences between people of different social groups (or whatever circumstantial factor you can think of), our priority with education should be to not favour or disfavour ANY particular demographic, based merely on incidental and general differences.
    See the difference there is, my anecdotes are plausible, yours are stupid. 'Love of luxury' doesn't motivate commitment, it encourages consumption.

    Secondly, you don't go to medical school. You haven't even been to university! How the **** can you compare your experiences of Sixth Form with mine of Oxford and Cambridge medical schools...
 
 
 
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