What can doctors do that ANPs (with prescribing rights) cannot?

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Democracy
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#21
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#21
(Original post by wildstar9)
Some are surgical first assistants so they can get involved lol
And by get involved, you mean "hold retractors". A surgical registrar clearly does way more than this when they're alone covering surgery.

The point of being a registrar is that you're learning to be a consultant. An ANP who's not doing this is not "working at reg level". They may be more confident and more experienced than a particular junior doctor at that point in time (possibly due to departmental reasons and not being shunted around every six months), but they are not de facto as competent as all registrars in that specialty. If they're at all sensible they'll be the first to point this out.
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Democracy
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(Original post by wildstar9)
That is true but on the other hand, I'm sure in a medical specialty they literally mirror the tasks of a Reg?
Mate are you high lol? Have you seen what a med reg does at night?
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ecolier
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#23
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(Original post by wildstar9)
That is true but on the other hand, I'm sure in a medical specialty they literally mirror the tasks of a Reg?
Not really. There are plenty of things a medical reg will do.

e.g. in Neurology I would see headache, Parkinson's Disease, epilepsy, MS and decide the treatment for all. I also authorise tertiary / quarternary investigations e.g. paranodal antibodies to be sent to Oxford neuro-immunology after an MDT discussion with the Walton Centre. I doubt the ANPs can do that.

Same for other medical specialties, and especially for general medical on-calls. There is no way any ANP can replace a medical reg anytime soon.


(Original post by wildstar9)
Do they do the same thing?
Back to your original questions, there is a lot of things that a doctor can do that the ANP cannot. For a start they would never be in charge of a patient - e.g. receive GP referrals, and decide whether an operation is required or whether it is appropriate.

They will also most likely be working under a consultant rather than leading the team.

Plus, while they can get involved in management they would probably never lead the surgical department or be head of that specialty, for example.

And of course, the pay will always be much lower compared to a specialist consultant surgeon; and I also doubt that there is much private practise opportunities.
Last edited by ecolier; 3 days ago
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wildstar9
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#24
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#24
(Original post by Democracy)
Mate are you high lol? Have you seen what a med reg does at night?
I have not completed my med rotation but from what I can see from surgery, they seem to be running the surgical ward when the consultant isn't there. They disagree and re-write plans by Reg (refusing to give some medications, fluids etc) without consulting them first.

During operations, they can also suture and do other small tasks - so I guess they will never get to the level of reg in a surgical specialty, but medical I think so.
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ecolier
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#25
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#25
(Original post by wildstar9)
I have not completed my med rotation but from what I can see from surgery, they seem to be running the surgical ward when the consultant isn't there. They disagree and re-write plans by Reg (refusing to give some medications, fluids etc) without consulting them first.

During operations, they can also suture and do other small tasks - so I guess they will never get to the level of reg in a surgical specialty, but medical I think so.
Surgical registrars are not the best in prescribing and medical management, let's put it that way.

On the ward, I have no doubt who I would trust more to look after the patients medically - and it's not the surgical reg.

You'll need more experience in working before making sweeping statements like "ANPs can be as good as a medical reg". Come back when you have done your MRCP diploma.
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wildstar9
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(Original post by ecolier)
Surgical registrars are not the best in prescribing and medical management, let's put it that way.

On the ward, I have no doubt who I would trust more to look after the patients medically - and it's not the surgical reg.

You'll need more experience in working before making sweeping statements like "ANPs can be as good as a medical reg". Come back when you have done your MRCP diploma.
Sorry I didn't mean any offense. I was just taken back how much responsibility they have.
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moonkatt
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#27
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(Original post by wildstar9)
I have not completed my med rotation but from what I can see from surgery, they seem to be running the surgical ward when the consultant isn't there. They disagree and re-write plans by Reg (refusing to give some medications, fluids etc) without consulting them first.

During operations, they can also suture and do other small tasks - so I guess they will never get to the level of reg in a surgical specialty, but medical I think so.
(Background to my reply, I'm a senior nurse working across site in my hospital, interacting with ANPs and medical/surgical staff of all flavours).

The consultants don't run wards, the nursing staff run them. That's why the senior sister on a ward is often called the ward manager.

ANPs have huge value in clinical practice, but there is no way they hold the same experience, or clinical authority as a specialty registrar. They often have a lot of knowledge around one very narrow area of clinical practice. They can disagree with plans by all means, however there are professional ways and means to go about this, if an ANP were to go round undermining a registrar's plans constantly without discussion it'd cause mayhem. Healthcare is a team based thing, if you're going to alter someone's plan, you should have the professional courtesy to consult them over it.

There's also no way an ANP is equal to a medical registrar, there's a huge difference in the level of responsibility, it's a colossal task and one I do not envy.
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Etomidate
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#28
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Getting the popcorn for this thread..

Where’s Anna Spanner/Subcutaneous when you need her 😂
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wildstar9
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#29
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#29
ANPs earn nearly 45k per year. I doubt most reg earn that until ST6+
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nexttime
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#30
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(Original post by wildstar9)
The ANPs in our SAU ward can do anything up to reg level..
You seem quite persistent on this point - do you have a bit of an agenda here?

In response to the above:
1) I bet they don't. I bet they don't make many medical decisions (rather than surgical). I bet they don't sign DNRs.
2) "Up to reg level" - so not as high as a doctor will become then? Haven't you sort of answered your own thread title?
3) Those trainees they are more knowldgable than are just that - trainees. They are learning about far broader areas than just surgical assessment - operating itself, running clinics. Maybe they don't even have any interest in surgery at all.

They can be super useful within their niche though. They have risen to fill the huge gaps in doctors staffing and the service would surely have collapsed without them.
(Original post by Anonymous)
What ANPs do very much dependon on where they are working I have worked in paediatric units where some ANPs were on the reg rota and could do anything a reg could do. However, they were limited to their specialty (neonates or paeds) and could not cross cover, whereas the paeds trainees were able to work in both specialties due to their training being more broad.

In adult medicine, the ANPs I have worked with have had very different roles in different places and whilst they had highly specialist knowledge in some areas (e.g on neurosurgery, they ran baclofen clinics and were trained in giving intrathecal injections - a highly specialist skill), they could not do something as simple as read an ECG because it was not their area of expertise.

So to answer your question, doctors' training provides them with a much broader base of knowledge and skills, whereas ANPs have a great depth of knowledge and skills in their area of expertise but they do not have aba of knowledge.
Yes agree. Not only do they tend to have a very narrow role, even within that role they often seem to have very prescriptive protocols.

There certainly are broader roles like the out of hours ANPs who help the ward cover team at night in my hospital, but they tend to just take the mundane tasks (looking at normal bloods, helping put in cannulas, occasionally simple medical problems) and have a very low threshold for phoning an actual doctor. Most of them would defer to the knowledge of an FY1 most of the time I suspect. The broader they are the less independent they are, of course.

Why anon though?!
(Original post by Angelic Roar)
So would you say the job is pretty easy? Do they work as much as doctors? I know some doctors work 7 days a week
No doctor works every day. In the UK anyway.

A lot of the ancillary supporting roles trying to fill the gaps do work more regular hours, less weekends etc. It depends on the role though and I suspect a surgical ANP covering the surgical admissions unit would be at least be covering weekends, possibly nights too.
(Original post by wildstar9)
Some are surgical first assistants so they can get involved lol
Being a first assistant for most operations is hardly a skilled task. If it weren't for the sterility requirements you could definitely train a monkey to do it.
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nexttime
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(Original post by wildstar9)
ANPs earn nearly 45k per year. I doubt most reg earn that until ST6+
You can't really tell as it depends on out of hours work etc, but that's about average for an ST1's wage. If those ANPs are getting £45k for only working 9-5 then its more like ST3 equivalent (which these days is the same as ST6).

But that wage is relatively flat, whereas a doctor can expect to progress and earn more. Doctors also have more lucrative locums.
Last edited by nexttime; 3 days ago
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LeapingLucy
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#32
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(Original post by Angelic Roar)
So would you say the job is pretty easy? Do they work as much as doctors? I know some doctors work 7 days a week
Doctors don’t work 7 days a week in general practice.

Each morning/afternoon is called a ‘session’ - even a full-time GP only does 8 sessions a week.

So the most you could do is 4 full-time days, or 5 days with a combination of full & half days.

I think being a practice nurse is definitely easier than being a hospital nurse - there are no night shifts for instance, and you work a set number of sessions (agreed between you & your practice) which are the same every week.

Some of the practice nurses did more sessions than some of the doctors. It’s really up to you how many sessions you want to work.
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Etomidate
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#33
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(Original post by wildstar9)
ANPs earn nearly 45k per year. I doubt most reg earn that until ST6+
Huh? That's essentially ST1/CT1 pay.
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wildstar9
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#34
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(Original post by Etomidate)
Huh? That's essentially ST1/CT1 pay.I
IS IT? wow
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