cactuspiral
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I'm applying for medicine, and I've dedicated my A-Level choices, volunteer work, work experience, gap year, UCAT prep, all towards doing medicine.

However, recently I've been having second thoughts.

I've been speaking to current doctors and reading forums for current doctors. They all complain about being stressed and having a poor work life balance, paying to do exams, etc which I'm not sure about.

Also, they said a big problem at the moment is the introduction of Advanced Practitioners and similar jobs are making the role of a doctor less valued, or meaning people can undertake the role of a mid-level doctor without having to commit to years of training etc.

I guess I'm just not sure what to do anymore. I feel like I'm losing the passion I had for medicine, but I'm not sure if there are any other jobs I'm interested in either.

Is medicine worth it? Will it be a good profession in say, ten, twenty years time? Or am I just better off doing something else?
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Wally2018
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(Original post by cactuspiral)
I'm applying for medicine, and I've dedicated my A-Level choices, volunteer work, work experience, gap year, UCAT prep, all towards doing medicine.

However, recently I've been having second thoughts.

I've been speaking to current doctors and reading forums for current doctors. They all complain about being stressed and having a poor work life balance, paying to do exams, etc which I'm not sure about.

Also, they said a big problem at the moment is the introduction of Advanced Practitioners and similar jobs are making the role of a doctor less valued, or meaning people can undertake the role of a mid-level doctor without having to commit to years of training etc.

I guess I'm just not sure what to do anymore. I feel like I'm losing the passion I had for medicine, but I'm not sure if there are any other jobs I'm interested in either.

Is medicine worth it? Will it be a good profession in say, ten, twenty years time? Or am I just better off doing something else?
It’s definitely worth it
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Democracy
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(Original post by cactuspiral)
I'm applying for medicine, and I've dedicated my A-Level choices, volunteer work, work experience, gap year, UCAT prep, all towards doing medicine.

However, recently I've been having second thoughts.

I've been speaking to current doctors and reading forums for current doctors. They all complain about being stressed and having a poor work life balance, paying to do exams, etc which I'm not sure about.

Also, they said a big problem at the moment is the introduction of Advanced Practitioners and similar jobs are making the role of a doctor less valued, or meaning people can undertake the role of a mid-level doctor without having to commit to years of training etc.

I guess I'm just not sure what to do anymore. I feel like I'm losing the passion I had for medicine, but I'm not sure if there are any other jobs I'm interested in either.

Is medicine worth it? Will it be a good profession in say, ten, twenty years time? Or am I just better off doing something else?
I think it is still worth it. Exams - yes, expensive but overall your salary will compensate.

Medicine is a varied profession. If you decide work-life balance is your ultimate priority there are ways of achieving this. You have to be realistic of course but speaking in general terms I think it's something achievable.

Midlevels - yeah, I can understand the concerns but I would still advocate taking the long view. A medical degree is a medical degree and is respected the world over. It is not the same as a midlevel qualification (despite what the Dunning-Kruger crowd would have you believe) and there is still value in rigorous medical training and a broad, in-depth knowledge base.
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Turning_A_Corner
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There are only around 4000 PAs in this country, possibly fewer I don’t know. But the idea that they are undermining the role of a doctor is shortsighted. Junior doctors rotate constantly in order to fulfil their training needs whereas PAs are permanent members of staff and you don’t lose skills. PAs are also involved in the training of junior doctors who are below them in experience, freeing consultants and registrars up to concentrate on more complex cases. They also plug a massive hole in staffing in the NHS and require only two years of initial training. Their introduction has been a massive success in the NHS. However, the scope for their career development is more limited than doctors’ careers. In that regard, you get out what you put in. More time training equals more options post graduation and better salaries long term. I work with a couple of PAs and advanced clinical practitioners and they basically describe it as being a junior doctor for life and whilst they’re okay with it, they know where their career is going to cap out. They don’t have the scope to expand their skills sets as doctors do. So if you’re looking for scope for growth, medicine is the way to go. If you just want a medical career but not all the aggro that comes with extended training, PA is the way to go.
Conditions wise, the entire NHS is suffering right now. You can’t get away from that. Until it’s better funded, these problems will continue. The jobs themselves, though, they’re still worth it. They’re just undervalued. People still get ill, people still need diagnosing and treating and there will never not be a role for doctors. It’s just if you can get past the hard part. And every healthcare role has a period where it’s hard and a bit rubbish while you’re learning. That’s a near universal.

Who can predict what the health service will be like in ten or twenty years? But I’d rather be part of the journey to shape it than on the sidelines guessing.
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Chief Wiggum
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It will depend on the individual. For me, it has been worth it.

I wouldn't say I am stressed. My work-life balance is OK, but for sure medicine is a busy career. The same will be true of law, banking etc. If you want to prioritise work-life balance, then you can. Some specialties will be better than others for this.

Paying to do exams is annoying - the NHS can get away with treating junior doctors like crap because they are a monopoly employer.

"Advanced Practitioners" haven't really had any impact on my job, other than I think that the Advanced Nurse Practitioners that I've worked with have been great and are a real asset to the team. Not something I've ever heard anyone complain about in real life.
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Letournel
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(Original post by cactuspiral)
I'm applying for medicine, and I've dedicated my A-Level choices, volunteer work, work experience, gap year, UCAT prep, all towards doing medicine.

However, recently I've been having second thoughts.

I've been speaking to current doctors and reading forums for current doctors. They all complain about being stressed and having a poor work life balance, paying to do exams, etc which I'm not sure about.

Also, they said a big problem at the moment is the introduction of Advanced Practitioners and similar jobs are making the role of a doctor less valued, or meaning people can undertake the role of a mid-level doctor without having to commit to years of training etc.

I guess I'm just not sure what to do anymore. I feel like I'm losing the passion I had for medicine, but I'm not sure if there are any other jobs I'm interested in either.

Is medicine worth it? Will it be a good profession in say, ten, twenty years time? Or am I just better off doing something else?
I still think my job is worth it, only 5 years in but genuinely have a lot of fun at work.

There are certainly some stressful moments but all in all it's fairly relaxed. Work life balance is certainly not brilliant compared to average but i imagine not that bad compared to other professional careers. Paying for exams is certainly frustrating but the salary is fairly decent assuming you're okay with money and aren't going to just waste your cash.

From the advanced practitioner point of view i've worked with plenty and don't feel there is any risk that they are coming for my job or that i am any less valued. In my specialty they certainly don't undertake the role of a mid-level.

The further i progress the better i think my job gets but that's mainly as i am doing what i want to do. I imagine that whilst further progress will bring with it its own challenges, being able to pursue my specific interests will keep me happy.
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Incidentaloma
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Another point to bear in mind is that people usually go to professional forums to vent or get advice about a specific problem, not to say how much they love their job. You'll get a skewed view if you just go by those posts.
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artful_lounger
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I would've thought having advanced practitioners around would be a good thing, as a non-medic; they can help meet service provision requirements, especially for more routine things that are part of the work of doctors, but that might not be the best use of their training. Doctors could then theoretically focus on leveraging their broad scientific background to tackle difficult or non-standard things that come up. Not sure if this is the case in reality of course...but I would've thought it might be preferred to have an advanced practitioner do that routine procedure that takes an hour but requires little to no thought but a medical degree to perform, compared to something else

Although I'm sure they have thoughts on the other concerns too, I'm actually somewhat interested to see what some of the other TSR doctors, that haven't replied here yet, think of the advanced practitioners "issue" flagged up here as well? nexttime GANFYD ecolier :holmes:

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(hopefully not poking a hornets nest here! )
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Democracy
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(Original post by artful_lounger)
I would've thought having advanced practitioners around would be a good thing, as a non-medic; they can help meet service provision requirements, especially for more routine things that are part of the work of doctors, but that might not be the best use of their training. Doctors could then theoretically focus on leveraging their broad scientific background to tackle difficult or non-standard things that come up. Not sure if this is the case in reality of course...but I would've thought it might be preferred to have an advanced practitioner do that routine procedure that takes an hour but requires little to no thought but a medical degree to perform, compared to something else

Although I'm sure they have thoughts on the other concerns too, I'm actually somewhat interested to see what some of the other TSR doctors, that haven't replied here yet, think of the advanced practitioners "issue" flagged up here as well? nexttime GANFYD ecolier :holmes:

Spoiler:
Show

(hopefully not poking a hornets nest here! )
Sounds lovely when its written like that.

Somewhere along the line it then evolved into "they're equivalent to registrars because of their magical training and if you don't want to do all their discharge summaries you are an elitist who needs re-education".

I wonder why this disconnect has arisen - it's almost like a strategist or politician with no healthcare experience was behind it all along
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nexttime
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(Original post by cactuspiral)
Also, they said a big problem at the moment is the introduction of Advanced Practitioners and similar jobs are making the role of a doctor less valued, or meaning people can undertake the role of a mid-level doctor without having to commit to years of training etc.
[Sorry this become long]

I might be wrong, but it feels like you've spoken to mainly more junior trainees when you say this?

I have heard complaints, about PAs in particular, not really ANPs, about them taking training opportunities. There's also an element of just bitterness: training is shorter, frequently having only 9-5 hours, shorter hours, stationary in one department so they learn the 'interesting' stuff, but unable to do boring admin tasks like all prescriptions, scan requests and discharge summaries, which have to be done by the doctor. And to top it off, they may well be paid more than you too!

That is a short term view though. When you become a senior SpR and consultant, all of those factors disappear (maybe except the 9-5 and longer hours bit).

The UK's training structure in general is a problem, leading to a lot of these views. The biggest factor is probably having you rotate hospitals throughout training. In for example medical training you are rotating department every 4 months for the first 5 years - it means you never belong. No one wants to train you, they don't bother giving you a even a locker. You barely have time to learn your colleagues names, and you don't get invited to the Christmas party. If you get into any kind of dispute everyone sides with the colleague they have to work with long term i.e. not you. Etc.

Not to take it too far - i found 95% of people to be perfectly pleasant. But I also got the impression that no one cared about how much I was learning in the slightest. It was entirely about whether you were getting the patient discharged on time or not.

Anyway - ANPs. I think once you get more senior, you appreciate them much more. Not least because without them, you'd just have to do their workload too right? But this does also have major implications about the type of work you do, which I think is going to be a major trend in the next 10-20 years, and that's being the head of an multi-professional team.

So take my specialty: oncology. In the past, you had one consultant running a disease site. You saw say 15 patients in a morning, you prescribe their chemo, gave them good news, gave them bad news, whatever. That was it - your 15 patients. Now: there will still be one consultant, but there will be 2 ANPs and a prescribing pharmacist too. They will have about 8 patients each (its a thing that ANPs work about half as fast as doctors - don't know why). So as a doctor you now have ideally fewer patients, maybe 10. But you're also supervising a team. And that team will need a lot of supervision. Firstly, they probably don't have full prescribing rights, so you have do to all that for them. Then, any problems and they will come to you to ask for help. I'm a trainee and sometimes I go to the consultant to ask something, and have to join a queue of 3 or 4 people, no joke. And then, if there are any issues after clinic - its not the ANPs that get called. Its the consultant. So now the consultant is getting calls about emergencies, any mistakes, any clarifications for all of these 10 and the 24 the ANPs saw. Plus, any complaints.

So its a different type of working - no longer are you just seeing your patients. You're constantly on the phone, answering emails, dealing with the queue outside your door, whilst seeing fewer patients yourself. To me, even if the actual workload was the same (doubtful), that is a far less pleasant daily routine! Obviously details will depend on specialty.

So liking ANPs? Sure. Are they better than just having another consultant? Highly doubtful!

Is medicine worth it? Will it be a good profession in say, ten, twenty years time? Or am I just better off doing something else?
Well that's question! Medicine is changing so fast its impossible to tell.

My main predictions would be:

1) Increased 'coordinator' role as above
2) Much more complicated specialist therapeutics, yet they've just shortened specialist training in favour of a more 'generalist' approach. I think this will result in a much more stark distinction between 'junior' consultants and 'senior' consultants.
3) Continued wage suppression - its dropped by about 30% in the last 12 years - and NHS funding problems, resulting in a much bigger private sector. I think doing private work will be a lot more normal.
(Original post by Turning_A_Corner)
Their introduction has been a massive success in the NHS.
That feels like a sufficiently bold and broad statement to need a citation.

I've seen a mix of PA usefulness. It is undeniable though that there was a gap and something had to fill it! Whether they are more useful than just having more doctors/nurses/pharmacists is a lot more complicated a question though.
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Muttley79
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The ANP that work in SCBU know more about the care of prem babies than doctors and the doctors ackbnowledge that ...
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Helenia
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(Original post by Muttley79)
The ANP that work in SCBU know more about the care of prem babies than doctors and the doctors ackbnowledge that ...
So why don't they just become the consultants and run the show then?

Absolutely no disputing that ANNPs will be far more skilled and experienced than an F2, or a junior paediatrician on one of their first neonates rotations - of course they would, they've been in that (highly specialised and exclusive) environment for years rather than days. But there's a training programme for neonatal medicine for a reason, and the consultants it produces at the end are the ones overseeing both the junior doctors and also the ANNPs.
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girl_in_black
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(Original post by Muttley79)
The ANP that work in SCBU know more about the care of prem babies than doctors and the doctors ackbnowledge that ...
Having been a junior doctor in SCBU, they absolutely do know more than the junior doctors. Some of them even act at registrar level. However, once a baby is over the age the SCBU covers, they are clueless, because their training is limited to one specific and very narrow area, as Helenia has pointed out. A paeds reg, on the other hand, can comfortably provide cover both for neonates, children, adolescents, and if it came to it, could probably deal with an adult emergency too. Having worked with ANPs in a lot of different settings (ranging from primary care to A&E to various inpatient specialties), they are absolutely great but they will never replace the role of a doctor - their training just does not have the breadth of training that doctors' training does.

To answer OP's question as to whether it is worth it, I think that is a difficult question to answer. When working in the right environment, I get 100% satisfaction out of my job, even when it's been a rubbish day, I haven't had lunch and had to stay 2 hours behind. When stuck in rotations that I hate, doing crap hours, never seeing friends and getting zero job satisfaction, all whilst trying to study for exams and building my CV, it has been grim and not going to lie, I have had times where I just wanted to not be a doctor any more. And I know people experience this in other jobs too, but in other jobs you can quit and move elsewhere whereas in medicine, you are stuck in a training programme and if you quit, you only real long-term options are to either go into another training programme, or to move abroad.

Would I get the satisfaction I get being an ANP? I don't know. They still get to interact with patients and do some problem solving, and their job is easier in the sense that they never have ultimate responsibly, but as you get more experienced and more senior, there comes a point when you do want autonomy, and I feel like you only really get that as a senior doctor. If you want a less stressful job and more control over your life (where you live and work, when you get annual leave etc.), ANP or PA, or even an AHP role, would probably be the more sensible route, but those roles are certainly not a surrogate for being a doctor.
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anonymous1912
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(Original post by cactuspiral)
I'm applying for medicine, and I've dedicated my A-Level choices, volunteer work, work experience, gap year, UCAT prep, all towards doing medicine.

However, recently I've been having second thoughts.

I've been speaking to current doctors and reading forums for current doctors. They all complain about being stressed and having a poor work life balance, paying to do exams, etc which I'm not sure about.

Also, they said a big problem at the moment is the introduction of Advanced Practitioners and similar jobs are making the role of a doctor less valued, or meaning people can undertake the role of a mid-level doctor without having to commit to years of training etc.

I guess I'm just not sure what to do anymore. I feel like I'm losing the passion I had for medicine, but I'm not sure if there are any other jobs I'm interested in either.

Is medicine worth it? Will it be a good profession in say, ten, twenty years time? Or am I just better off doing something else?
If you're having to ask that question, I don't know if it will be good in the long run for you, but whatever you do, good luck.
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nexttime
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(Original post by anonymous1912)
If you're having to ask that question, I don't know if it will be good in the long run for you, but whatever you do, good luck.
I disagree. They've clearly done lots of research and are acknowledging both the downsides and the alternatives. If they come through that still wanting to do medicine, then I think they're better placed to be a doctor than someone who just decided when they were five and shut their ears to any other possibilities.
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anonymous1912
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(Original post by nexttime)
I disagree. They've clearly done lots of research and are acknowledging both the downsides and the alternatives. If they come through that still wanting to do medicine, then I think they're better placed to be a doctor than someone who just decided when they were five and shut their ears to any other possibilities.
I agree to disagree to agree in order for you not to agree. You do have a point but that point stands nowhere near as important as my point. Do you see the point I'm making?
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girl_in_black
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(Original post by anonymous1912)
I agree to disagree to agree in order for you not to agree. You do have a point but that point stands nowhere near as important as my point. Do you see the point I'm making?
What point are you making? OP has asked for opinions from people doing the job he/she is interested in doing , and their questions and doubts are entirely reasonable considering medical training is a pretty big commitment to make.
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malshoha
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(Original post by cactuspiral)
I'm applying for medicine, and I've dedicated my A-Level choices, volunteer work, work experience, gap year, UCAT prep, all towards doing medicine.

However, recently I've been having second thoughts.

I've been speaking to current doctors and reading forums for current doctors. They all complain about being stressed and having a poor work life balance, paying to do exams, etc which I'm not sure about.

Also, they said a big problem at the moment is the introduction of Advanced Practitioners and similar jobs are making the role of a doctor less valued, or meaning people can undertake the role of a mid-level doctor without having to commit to years of training etc.

I guess I'm just not sure what to do anymore. I feel like I'm losing the passion I had for medicine, but I'm not sure if there are any other jobs I'm interested in either.

Is medicine worth it? Will it be a good profession in say, ten, twenty years time? Or am I just better off doing something else?
What specialty are you looking to go into and why?
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