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    I definitely like the thought of being a GP but I love the hospital environment!
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    (Original post by FlavaFavourFruit)
    I definitely like the thought of being a GP but I love the hospital environment!
    Maybe I'm an example of the fact that the novelty can wear off after a few years! I very seriously considered a career in Obs and Gynae but have no Y chromosome and felt 100% keen to have a family so wanted a career that could switch between part time/full time when necessary...
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    (Original post by Dr Gin)
    Maybe I'm an example of the fact that the novelty can wear off after a few years! I very seriously considered a career in Obs and Gynae but have no Y chromosome and felt 100% keen to have a family so wanted a career that could switch between part time/full time when necessary...
    Yeah I guess so, I worked as a HCA for 9 months but after 6 months, I got fed up of it all, the job the hospital

    Yeah GP is also family orientated! By the way, there were plans to increase GP surgeries for 12 hours a day, 7 days a week. They're doing a pilot study atm and apparently some surgeries open for 12 hours.

    What do you think of this and will it affect the A&E pressure?
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    (Original post by FlavaFavourFruit)
    Yeah I guess so, I worked as a HCA for 9 months but after 6 months, I got fed up of it all, the job the hospital

    Yeah GP is also family orientated! By the way, there were plans to increase GP surgeries for 12 hours a day, 7 days a week. They're doing a pilot study atm and apparently some surgeries open for 12 hours.

    What do you think of this and will it affect the A&E pressure?
    At the last major contract shake-up the government (labour at the time) got things a bit wrong really and out-of-hours care got 'dumped' by many GPs who were glad to have an opportunity to regain some family hours and see their children before bedtime. Since then there have been lots of attempts to improve access (i.e. get us to work the more 'unsociable' hours again) and so many surgeries have been open from 7 am or working til 8pm 5 days a week plus opening on Saturday mornings to try to improve things and get waiting times down. The 8 'til 8 centres were a major part of the plan but these don't appeal to all patients as many feel that they want their own GP to deal with them because they have complex past history/care needs.
    My normal working day would be 8.30 til 7 anyway so a 12 hour stint wouldn't make much difference to me or to the number of patients I could deal with. I take no lunch break (I field problems for the receptionists and telephone patients with results whilst scoffing a sandwich) so it's a pretty full-on day anyway. Hard to see how an hour or two of my time could make all the impact needed but I'm sure that it will improve things in some areas (you could speak to 10 GPs and hear about 10 completely different working patterns). The main problem in my working life is that the NHS can only afford for each patient to have a problem that takes 8 minutes to deal with and, in many cases (most for some of us) this simply isn't real life. Also, if I stretched my day any further I would probably have to stick a proper break in there and I doubt I'd have much increased contact time with patients overall. To open surgeries 12 hours a day realistically they will need to increase the GP population further and that costs more. The NHS has no extra money to spend at the moment so it just doesn't all add up...




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    (Original post by Dr Gin)
    At the last major contract shake-up the government (labour at the time) got things a bit wrong really and out-of-hours care got 'dumped' by many GPs who were glad to have an opportunity to regain some family hours and see their children before bedtime. Since then there have been lots of attempts to improve access (i.e. get us to work the more 'unsociable' hours again) and so many surgeries have been open from 7 am or working til 8pm 5 days a week plus opening on Saturday mornings to try to improve things and get waiting times down. The 8 'til 8 centres were a major part of the plan but these don't appeal to all patients as many feel that they want their own GP to deal with them because they have complex past history/care needs.
    My normal working day would be 8.30 til 7 anyway so a 12 hour stint wouldn't make much difference to me or to the number of patients I could deal with. I take no lunch break (I field problems for the receptionists and telephone patients with results whilst scoffing a sandwich) so it's a pretty full-on day anyway. Hard to see how an hour or two of my time could make all the impact needed but I'm sure that it will improve things in some areas (you could speak to 10 GPs and hear about 10 completely different working patterns). The main problem in my working life is that the NHS can only afford for each patient to have a problem that takes 8 minutes to deal with and, in many cases (most for some of us) this simply isn't real life. Also, if I stretched my day any further I would probably have to stick a proper break in there and I doubt I'd have much increased contact time with patients overall. To open surgeries 12 hours a day realistically they will need to increase the GP population further and that costs more. The NHS has no extra money to spend at the moment so it just doesn't all add up...



    Thank you very much! Very informative, hate the idea of a rushed lunch but I see that everywhere in the clinical setting
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    (Original post by FlavaFavourFruit)
    Thank you very much! Very informative, hate the idea of a rushed lunch but I see that everywhere in the clinical setting
    Hopefully it'll keep us all skinny
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    (Original post by Dr Gin)
    Hopefully it'll keep us all skinny
    I've always wondered why doctors are always really skinny

    I go to the hospital frequently and I'm yet to see an overweight doctor :/ at least if I end up as one, my weight can be easily controlled

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    (Original post by Aniaa)
    well actaully I am from Poland and hospitals there tend not to accept doctos from UK because they are uneducated.

    I applied for medicine in UK because I anyway want to study there
    Having had first-hand experience of Polish medical care, they really should reassess that policy... If you're so passionate about being a good doctor, why would you want to train in the country that provides (according to you) the worst medical education in Europe?
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    (Original post by MrSupernova)
    Having had first-hand experience of Polish medical care, they really should reassess that policy... If you're so passionate about being a good doctor, why would you want to train in the country that provides (according to you) the worst medical education in Europe?
    Hahahahaha
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    (Original post by MrSupernova)
    Having had first-hand experience of Polish medical care, they really should reassess that policy... If you're so passionate about being a good doctor, why would you want to train in the country that provides (according to you) the worst medical education in Europe?
    I didnt say according to me.
    and well, visiting one of the top UK medical school I can say it totally doesnt look like it was described in their prospectus. Don't judge all Polish doctors because you met a bad one. What if he was educated in UK?
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    Ok, one question:

    An elderly patient passes away from a serious illness that their family were unaware of but are now demanding answers. What would you do?

    Edit: aannd another one

    A patient is due for surgery. Due to his smoking and obesity, he is not fit for it. How would you explain it to him?

    Thank you a thousand and one times in advance for your reply
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    (Original post by Eva.Gregoria)
    Ok, one question:

    An elderly patient passes away from a serious illness that their family were unaware of but are now demanding answers. What would you do?

    Edit: aannd another one

    A patient is due for surgery. Due to his smoking and obesity, he is not fit for it. How would you explain it to him?

    Thank you a thousand and one times in advance for your reply
    Hi,
    Ok those are good questions I'll try my best to answer them
    So in this scenario the key is communication with the family. You as a doctor would explain to the family the element of confidentiality, you have to explain that it was the patients wishes that the information about his health be kept confidential. Because the patient is passed away, I think you could be able to further discuss the patients condition with the family as this would do no harm to the patient following the guidelines of the non malificience principle. It also may be important to involve the nurse and other health workers looking after this patient who can give reassurance to the family. Also ask the family what they already know about the patient, did they not visit him before he was admitted into the hospital? On the other hand the family may have been entirely excluded by the patient so you would have to respect that and assess what they already know. It's good to see in these situations if there is an advanced directive highlighting the patients wishes, if not simply act in the patients best interests. If the family is angry, understand their emotions inform them about then formation of confidentiality to the patient as well as your career.
    Hope this helps.
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    (Original post by Eva.Gregoria)
    Ok, one question:

    An elderly patient passes away from a serious illness that their family were unaware of but are now demanding answers. What would you do?

    Edit: aannd another one

    A patient is due for surgery. Due to his smoking and obesity, he is not fit for it. How would you explain it to him?

    Thank you a thousand and one times in advance for your reply
    Ok so the second one
    Ok so again communicating with the patient is key again. Firstly ask the patient what they know about their condition and it's treatment and their exercise regime and wether they think they are taking good care of their health. Once you know what the patient knows it will mean that you can directly guide the patient towards discussion. By acting in the patients best interests you would have to explain that the surgery is not in the best interests so it is being denied ie there are too many complications and it may do more harm than good. I've them time for this to sink in. BUT inform them of any supplementary care that is available so they can work on the obesity and smoking problem. Recommend the services of a dietician, prescribe him any meds he may need, so by postponing the operation there is a greater Chance of survival. BUT some patients are arrogant so if he still wants the surgery then recommend the services of another trust or doctor. In my opinion I doubt any trust or competent doctor would allow him to undergo the surgery.

    Hope it helps
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    I've been selected for an in interview checked the info on TSR but it's very little and broad. Could anyone help with some more advice on how to prepare for interview and what to expect please?
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    Guys I'm getting very frustrated and confused as some medical experts I've met say capacity for consent for minors is called 'Frazer Competence' whereas all my relevant sources (books internet, etc.) say it is called 'Gillick Competence'…which one is it?

    I don't want to say the wrong one in an interview.
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    (Original post by PG593)
    Guys I'm getting very frustrated and confused as some medical experts I've met say capacity for consent for minors is called 'Frazer Competence' whereas all my relevant sources (books internet, etc.) say it is called 'Gillick Competence'…which one is it?

    I don't want to say the wrong one in an interview.
    Gillick competence is no longer used, it is now the Fraser guidelines that are used.
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    (Original post by PG593)
    Guys I'm getting very frustrated and confused as some medical experts I've met say capacity for consent for minors is called 'Frazer Competence' whereas all my relevant sources (books internet, etc.) say it is called 'Gillick Competence'…which one is it?

    I don't want to say the wrong one in an interview.
    I'm not sure but it seems like they are two different things, with it being Gillick competence and Fraser guidelines. This might help http://www.nspcc.org.uk/inform/resea..._wda61289.html
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    (Original post by Slsam)
    Gillick competence is no longer used, it is now the Fraser guidelines that are used.
    (Original post by lovelycup7)
    I'm not sure but it seems like they are two different things, with it being Gillick competence and Fraser guidelines. This might help http://www.nspcc.org.uk/inform/resea..._wda61289.html
    Yes, but Frazer guidelines (shown on the NSPCC site) seem to refer specifically to contraception advice and treatment.

    I'm referring to a minor <16 making decisions about their health in general (without parents consent).

    I'm confused whether Frazer guidelines would be the terminology used for that or whether it's just for contraception situations.
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    (Original post by PG593)
    Yes, but Frazer guidelines (shown on the NSPCC site) seem to refer specifically to contraception advice and treatment.

    I'm referring to a minor <16 making decisions about their health in general (without parents consent).

    I'm confused whether Frazer guidelines would be the terminology used for that or whether it's just for contraception situations.
    Ahh yes I see what you mean!

    It says on the website:

    'Gillick competency and Fraser guidelines refer to a legal case which looked specifically at whether doctors should be able to give contraceptive advice or treatment to under 16-year-olds without parental consent. But since then, they have been more widely used to help assess whether a child has the maturity to make their own decisions and to understand the implications of those decisions.'

    So it looks like whilst they were originally put in place as guidelines specifically for the case of contraception being given to under 16's without parental consent, they are now used in a much wider context. So I think you can still use them in your case
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    (Original post by lovelycup7)
    Ahh yes I see what you mean!

    It says on the website:

    'Gillick competency and Fraser guidelines refer to a legal case which looked specifically at whether doctors should be able to give contraceptive advice or treatment to under 16-year-olds without parental consent. But since then, they have been more widely used to help assess whether a child has the maturity to make their own decisions and to understand the implications of those decisions.'

    So it looks like whilst they were originally put in place as guidelines specifically for the case of contraception being given to under 16's without parental consent, they are now used in a much wider context. So I think you can still use them in your case
    Awesome, good to have backup opinions on here Thank you!
 
 
 
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