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    Should there be other routes into becoming a doctor in addition to Medical School?

    With very high tuition fees and cost of living as a student, 5-6 years at medical school can seem daunting. There are a shortage of doctors in Britain and getting into Medical School is so hard that few even consider applying.

    My idea is that people who want to become doctors could take a more vocational route by becoming nurses, health care assistants or physicians assistants. Here they would gain invaluable clinical experience working in hospitals with modules they can take that would work towards an eventual medical degree. They would learn all the things a medical student learns such as anatomy and physiology, pathology etc but some of it would be learnt on the job and they would get a regular income. They would get the same assessments university medical students get and the same standards to pass would be required.

    You could say it's a bit like an apprenticeship in medicine.
    Also unlike Uni entry may not be so strict, as progress could be via a rank system.


    It may take a different length of time but at graduation you'd have new doctors who are highly experienced and hit the ground running. They'd then have all the options any other dcctor has after F1 and 2 such as becoming a: GP, surgeon, consultant, specialist etc.

    Opinions please?
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    (Original post by Ambitious1999)
    Should there be other routes into becoming a doctor in addition to Medical School?

    With very high tuition fees and cost of living as a student, 5-6 years at medical school can seem daunting. There are a shortage of doctors in Britain and getting into Medical School is so hard that few even consider applying.

    My idea is that people who want to become doctors could take a more vocational route by becoming nurses, health care assistants or physicians assistants. Here they would gain invaluable clinical experience working in hospitals with modules they can take that would work towards an eventual medical degree. They would learn all the things a medical student learns such as anatomy and physiology, pathology etc but some of it would be learnt on the job and they would get a regular income. They would get the same assessments university medical students get and the same standards to pass would be required.

    You could say it's a bit like an apprenticeship in medicine.
    Also unlike Uni entry may not be so strict, as progress could be via a rank system.


    It may take a different length of time but at graduation you'd have new doctors who are highly experienced and hit the ground running. They'd then have all the options any other dcctor has after F1 and 2 such as becoming a: GP, surgeon, consultant, specialist etc.

    Opinions please?
    Once upon a time it was done like that but it was a very long time ago.

    Being a doctor is a very complicated job and requires a lot of knowledge.

    I dare say being a gp in the training manner you suggest would be fine for 90% of the people who see them as it’s repetitive cases which an educated eye could sort out.

    The other 10% though are more complex and require all that special knowledge as does all the hospital doctors.
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    (Original post by Ambitious1999)
    Should there be other routes into becoming a doctor in addition to Medical School?

    With very high tuition fees and cost of living as a student, 5-6 years at medical school can seem daunting. There are a shortage of doctors in Britain and getting into Medical School is so hard that few even consider applying.

    My idea is that people who want to become doctors could take a more vocational route by becoming nurses, health care assistants or physicians assistants. Here they would gain invaluable clinical experience working in hospitals with modules they can take that would work towards an eventual medical degree. They would learn all the things a medical student learns such as anatomy and physiology, pathology etc but some of it would be learnt on the job and they would get a regular income. They would get the same assessments university medical students get and the same standards to pass would be required.

    You could say it's a bit like an apprenticeship in medicine.
    Also unlike Uni entry may not be so strict, as progress could be via a rank system.


    It may take a different length of time but at graduation you'd have new doctors who are highly experienced and hit the ground running. They'd then have all the options any other dcctor has after F1 and 2 such as becoming a: GP, surgeon, consultant, specialist etc.

    Opinions please?
    Medicine is an incredibly academically rigorous degree where students with even A*s and As struggle with and drop out. There's no way someone who's done something like nursing with hands on experience will be able to definitely handle the medical school tests.

    Medical experience is important but there's really no need for going as far as an apprenticeship. All medical schools in the UK are required to have some sort of hospital facility anyway.

    But ultimately the biggest problem is someone with vocational qualifications does not have the calibre to be capable of doing the work a doctor does, never mind specialising.

    The problem we have is the BMA. They have a lot of power and they restrict and cap the no. of students allowed to become doctors every year and unis that want to become medical schools face tough standards to meet. Medical school isn't that hard to get into in terms of grades (A*AA-AAA - There are plenty of students that can easily achieve this) and many capable students get knocked out due to the competition. Even grad school medicine is hard to get into.

    Edit:small mistake, ive been misinformed and it's not the bMA that put the cap
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    (Original post by paul514)
    Once upon a time it was done like that but it was a very long time ago.

    Being a doctor is a very complicated job and requires a lot of knowledge.

    I dare say being a gp in the training manner you suggest would be fine for 90% of the people who see them as it’s repetitive cases which an educated eye could sort out.

    The other 10% though are more complex and require all that special knowledge as does all the hospital doctors.
    "An educated eye"? Do you really think 90% go there for paracetamol or something? Sorry but you're clearly very naive or ignorant.
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    There isn't the time to learn the anatomy, pharmacology, physiology etc on the job because the clinicians are busy treating patients. You need to sit down for an hour to learn about anti arrhythmics and the If Na channels and there isn't the capacity to do this "on the job".

    Medicine ultimately has very academic foundations and can no longer be learned vocationally. The vocational learning that does occur requires a large amount of assumed knowledge.
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    In theory, I'd have nothing against a more "on the job" learning course, but they'd still have to learn all the same stuff anyway if you want to make it comparable, so it shouldn't really be any easier than a normal med course. So whilst I've nothing against it, would it really add much?

    To be honest, I do think medicine courses could probably be shortened. Perhaps I'm being naive, but I genuinely think the medicine course could be shortened to 4 years.
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    (Original post by friyaa23)
    "An educated eye"? Do you really think 90% go there for paracetamol or something? Sorry but you're clearly very naive or ignorant.
    No,

    I think a lot of gp medicine is something they see repeatedly all day. So be that writing a letter, repeat prescriptions, blood pressure tests checking something is normal and so on.
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    (Original post by friyaa23)
    Medicine is an incredibly academically rigorous degree where students with even A*s and As struggle with and drop out. There's no way someone who's done something like nursing with hands on experience will be able to definitely handle the medical school tests.

    Medical experience is important but there's really no need for going as far as an apprenticeship. All medical schools in the UK are required to have some sort of hospital facility anyway.

    But ultimately the biggest problem is someone with vocational qualifications does not have the calibre to be capable of doing the work a doctor does, never mind specialising.

    The problem we have is the BMA. They have a lot of power and they restrict and cap the no. of students allowed to become doctors every year and unis that want to become medical schools face tough standards to meet. Medical school isn't that hard to get into in terms of grades (A*AA-AAA - There are plenty of students that can easily achieve this) and many capable students get knocked out due to the competition. Even grad school medicine is hard to get into.
    I assume you mean that nurses would struggle with a top up scheme and not a medical degree, because I will tell you that plenty of nurses are academically capable enough to complete medical degrees.

    I agree that the nursing degree, as it stands, does not give a solid enough basis to allow a simple top up scheme to become a doctor. There simply isn’t enough a&p, pharmacology, history taking etc taught during a nursing degree. Most nurses pick this up after, from experience. I do think however, that there should be more graduate entry schemes (I.e. the full four year course) aimed at all allied health professionals, as the insight and skills they bring is invaluable.

    Oh and the AAA+ requirements are in large part due to competition. Go back 15 +years ago and people got in with Cs and Ds. And their are plenty of graduate with less than stellar a levels that excel in medical exams. I don’t think A levels are that good a prediction of future performance at all.
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    (Original post by Chief Wiggum)
    In theory, I'd have nothing against a more "on the job" learning course, but they'd still have to learn all the same stuff anyway if you want to make it comparable, so it shouldn't really be any easier than a norml med course. So whilst I've nothing against it, would it really add much?

    To be honest, I do think medicine courses could probably be shortened. Perhaps I'm beinug naive, but I genuinely think the medicine course could be shortened to 4 years.
    Graduate Entry Medicine is a 4 year course with the exception of Imperial
    https://wwwf.imperial.ac.uk/blog/fom...-from-2015-16/

    Most university courses could be shortened. My Biology degree has a three month summer holiday, one month Easter holiday and three week Christmas holiday. Really not good value for money is it. However, a medical degree covers so much more in terms of what you need to know that making it shorter would burn out so many students (especially spoon-fed 18 year olds) plus would make intercalating impossible.
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    30.years ago you needed bbc or bbb for medicine. And less did A levels and there were no A *. So you have always needed top A level grades.
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    (Original post by Ambitious1999)
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    I've no issues with what you suggest in theory, but in practice, few allied healthcare professionals or nurses would be willing or able to go part time to do it and I wouldn't be surprised if a large proportion of students dropped out after the endless years of part time study.

    We're basically talking about studying part time for at least 7-8 years in order to graduate and start at the bottom rung of the ladder. Many of these other health professionals will already be in their mid to late twenties with bills to pay and children to look after. It's just not worth it.

    The answer is increasing medical school places for undergraduates and paying doctors properly. Plain and simple.
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    (Original post by Ambitious1999)
    Should there be other routes into becoming a doctor in addition to Medical School?

    With very high tuition fees and cost of living as a student, 5-6 years at medical school can seem daunting. There are a shortage of doctors in Britain and getting into Medical School is so hard that few even consider applying.

    My idea is that people who want to become doctors could take a more vocational route by becoming nurses, health care assistants or physicians assistants. Here they would gain invaluable clinical experience working in hospitals with modules they can take that would work towards an eventual medical degree. They would learn all the things a medical student learns such as anatomy and physiology, pathology etc but some of it would be learnt on the job and they would get a regular income. They would get the same assessments university medical students get and the same standards to pass would be required.

    You could say it's a bit like an apprenticeship in medicine.
    Also unlike Uni entry may not be so strict, as progress could be via a rank system.


    It may take a different length of time but at graduation you'd have new doctors who are highly experienced and hit the ground running. They'd then have all the options any other dcctor has after F1 and 2 such as becoming a: GP, surgeon, consultant, specialist etc.

    Opinions please?
    It's an interesting idea, but the amount of knowledge required to be a doctor is not something we can assume they'll learn on the job. It would take about twice as long if nurses were learning on the job and doing modules outside of that. Being involved in healthcare as a nurse does not nearly qualify you to be a doctor. At the end of the day, its something that needs to be taught over 5-6 years at University, and it's hard to get into because it's academically hard to do.

    I agree that it's both expensive and daunting, though.
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    I think this would be an unwise idea and a waste of time and money. A 4 year GEM degree is a more streamlined and cohesive way to bring staff or older individuals into medicine and learning in a structured way would be much more efficient than what you are suggesting. Also, I have worked as a healthcare assistant (alongside my undergrad in biomed) and learnt precisely zero clinical medicine - I learnt lots and lots of stuff about communication, how to wash a patient and how wards work though! PAs are a two year postgrad degree anyway - so 3yrs undergrad + 2yrs PA degree = 5 years, in which time you can train as a doctor anyway. I think that what you are suggesting would lead to very, very high drop-out rates and concerns about the standards of the graduates.

    Answer would be to increase the number of medical school places, this is happening but too slowly - expanding GEM makes sense at first as it is the quickest doctor production line.

    The government is actually making moves to do what you suggest but with nursing, HCAs are being encouraged to qualify 'on the job' rather than doing a nursing degree, which as a former HCA I think is excellent as I felt there were many, many valuable and skilled HCAs who'd been working in the role for decades sometimes with no meaningful progression despite their skills.

    I think it's important to note though, pragmatically the DoH needs to care about increasing the supply of UK doctors, this could be done whilst maintaining the high academic and work experience standards due to the glut of decent applicants who do not get a place at medical school.
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    (Original post by redhelen)
    30.years ago you needed bbc or bbb for medicine. And less did A levels and there were no A *. So you have always needed top A level grades.
    There has been substantial grade inflation since then, I think Ed Milliband got into Oxford with DDD or something (helps if your dad is a famous marxist academic ofc)
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    Oxford used to give EE offers if you passed their entrance exam and interview.
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    Is there anything that wasn't easier for baby boomers!
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    (Original post by paul514)
    No,

    I think a lot of gp medicine is something they see repeatedly all day. So be that writing a letter, repeat prescriptions, blood pressure tests checking something is normal and so on.
    LOL

    I’ve just finished my GP placement and while yes, a part of it is prescriptions and some referrals the majority is consultations and treatments.
    In 1 week there were 4 patients who were sent from the practice to a&e. One had appendicitis, 1 had a classic MI and the other was having a silent MI and the last one had ?sepsis.
    You need to be able to recognize major things and deal with appropriately; on the other hand you need to be competent enough to deal with the minor/intermediate stuff so you don’t send people en mass to clog up the emergency department.
    GP is frontline medicine, you don’t know what is coming in but are expected to have the knowledge to deal with it. It may not always be as acute as A&E but you still need to know quite a lot to sort the wheat from the chaff.
    BPs are done by treatment rooms or practice nurses, and only if incredibly high/dramatic change from normal they will refer to GP.

    Tbh, loads of nurses are doing the independent prescribed thing as are pharmacists and Physio. That is much more helpful than them doing a “night course” in medicine on the side as they wouldn’t be able to work and do the intensity of medical study and still have a life/or sleep lol.
    Medicine is still a type of apprenticeship tbh, you have to study at home and then have placement during the day where you will be actively putting knowledge into practice.
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    (Original post by ahorey)
    LOL

    I’ve just finished my GP placement and while yes, a part of it is prescriptions and some referrals the majority is consultations and treatments.
    In 1 week there were 4 patients who were sent from the practice to a&e. One had appendicitis, 1 had a classic MI and the other was having a silent MI and the last one had ?sepsis.
    You need to be able to recognize major things and deal with appropriately; on the other hand you need to be competent enough to deal with the minor/intermediate stuff so you don’t send people en mass to clog up the emergency department.
    GP is frontline medicine, you don’t know what is coming in but are expected to have the knowledge to deal with it. It may not always be as acute as A&E but you still need to know quite a lot to sort the wheat from the chaff.
    BPs are done by treatment rooms or practice nurses, and only if incredibly high/dramatic change from normal they will refer to GP.

    Tbh, loads of nurses are doing the independent prescribed thing as are pharmacists and Physio. That is much more helpful than them doing a “night course” in medicine on the side as they wouldn’t be able to work and do the intensity of medical study and still have a life/or sleep lol.
    Medicine is still a type of apprenticeship tbh, you have to study at home and then have placement during the day where you will be actively putting knowledge into practice.
    I don’t disagree like I said they need all the training for those none standard appointments.....
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    If you're saying that the problem is that potential medical students are being put off by the prospect of huge student debts, then that's a problem which needs addressing at a governmental level (something which political parties are apparently waking up to slowly). Coming up with a two tier system for training doesn't address the issue you've identified - for a start, why should one group of student doctors receive a salary during their training whilst another group accumulate £60K+ worth of debt?

    Something else to consider is that junior doctors are delaying entering specialty training/actively avoiding certain specialties and consultants are increasingly retiring early, and both groups of doctors are increasingly likely to emigrate and work abroad. That should tell you there is an ongoing issue with working conditions and morale in the NHS - coming up with an alternative training system does nothing to address that, since any doctors trained under the new system you're proposing will still end up experiencing the same workplace issues and will likely end up similarly delaying training/emigrating/retiring.

    Other users have already touched on the fact that you can't effectively learn medical science on the job. Whilst clinical experience is an important part of developing as a doctor, you need to understand the science behind what you're doing, and for that you need a traditional university education with proper book learning and teaching.

    We need to stop coming up with convoluted quasi-solutions which skirt around the actual issues - the system of medical education we currently have can work perfectly well if it's actually allowed to.


    (Original post by friyaa23;74022822
    The problem we have is the BMA. They have a lot of power and they restrict and cap the no. of students allowed to become doctors every year and unis that want to become medical schools face tough standards to meet. Medical school isn't [i
    )

    that [/i]hard to get into in terms of grades (A*AA-AAA - There are plenty of students that can easily achieve this) and many capable students get knocked out due to the competition. Even grad school medicine is hard to get into.
    The Department of Health expands/restricts the number of places at medical schools not the BMA.
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    (Original post by Democracy)
    If you're saying that the problem is that potential medical students are being put off by the prospect of huge student debts, then that's a problem which needs addressing at a governmental level (something which political parties are apparently waking up to slowly). Coming up with a two tier system for training doesn't address the issue you've identified - for a start, why should one group of student doctors receive a salary during their training whilst another group accumulate £60K+ worth of debt?

    Something else to consider is that junior doctors are delaying entering specialty training/actively avoiding certain specialties and consultants are increasingly retiring early, and both groups of doctors are increasingly likely to emigrate and work abroad. That should tell you there is an ongoing issue with working conditions and morale in the NHS - coming up with an alternative training system does nothing to address that, since any doctors trained under the new system you're proposing will still end up experiencing the same workplace issues and will likely end up similarly delaying training/emigrating/retiring.

    Other users have already touched on the fact that you can't effectively learn medical science on the job. Whilst clinical experience is an important part of developing as a doctor, you need to understand the science behind what you're doing, and for that you need a traditional university education with proper book learning and teaching.

    We need to stop coming up with convoluted quasi-solutions which skirt around the actual issues - the system of medical education we currently have can work perfectly well if it's actually allowed to.




    The Department of Health expands/restricts the number of places at medical schools not the BMA.
    no it's me. sorry geezers
 
 
 
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