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Modernising Medical Careers - The Current Situation

I know a few years back there was a lot of anger over MMC and MTAS. I was just wondering if anything's changed. Has the whole situation improved, worsened or still pretty messed up like it was in 2005? It's slightly off-putting knowing that you're applying to study for a vocation where you can easily end up unemployed or forced to emigrate and in a system that's being 'dumbed down'.

Reply 1

Renal

17

Still mostly ****** up. The job prospects aren't quite as dire as they were for the lost tribe anymore, but it's still ****. And you're right; it is 'off-putting'.

Reply 2

terpineol

14

"Off putting"?

I would say its completely and utterly demotivating. Hence my constant development of my skills to make me more competitive in any other line of work.

Reply 3

7589200

18

the whole prospect of applying for a medical job scares me
I really really really want to go to America

Reply 4

DhobyGhaut

OP

9

Hmm...maybe my sarky understatement didn't work...

I'm interested in the attitude of other medical students. Are a lot of them going to go and slog it out, quit, etc.? I'm surprised lots of people don't know/don't care and still want to go into medicine. I know everyone says "I want to help people" and maybe some actually do but surely some thought has to be given to the career prospects.

Reply 5

RollerBall

20

WackyJun

Hmm...maybe my sarky understatement didn't work...

I'm interested in the attitude of other medical students. Are a lot of them going to go and slog it out, quit, etc.? I'm surprised lots of people don't know/don't care and still want to go into medicine. I know everyone says "I want to help people" and maybe some actually do but surely some thought has to be given to the career prospects.

Well for now, my limited knowledge is you will get a placement. It just might not be what you want. MTAS was a fiasco, people having to re-apply for their own jobs is abysmal. But it will probably be replaced with another crappy system.

But hey, I've still got a long time till that and things will undoubtable have changed by then. And like I said, limited knowledge and all that so this post is probablt fraut with errors.

Reply 6

Helenia

20

WackyJun

Hmm...maybe my sarky understatement didn't work...

I'm interested in the attitude of other medical students. Are a lot of them going to go and slog it out, quit, etc.? I'm surprised lots of people don't know/don't care and still want to go into medicine. I know everyone says "I want to help people" and maybe some actually do but surely some thought has to be given to the career prospects.

Well, speaking from the perspective of the older medical students here, all this **** hit the fan when we were more than halfway through our degrees. It would have been pretty stupid to bail at that point, leaving ourselves with half a degree and no idea what else to do, plus not knowing if it would still be crap by the time we got there. Now I'm a final year, and the rest of the country is in recession, but I've got a guaranteed job for the next two years assuming I don't screw up royally, which is more than a lot of people about to graduate. So it's not all doom and gloom, nor is it necessarily easy to get out once you're in.

Of my year, all but one (I think) are going onto the foundation programme. As for where we'll go later, I don't know. A few have started taking the USMLE, but most of us wouldn't go near the States. There are also a few considering doing their F2 in Australia/NZ, and some of them may not come back. Most of us are still reasonably optimistic that the situation might have improved slightly by the time we're applying for ST posts, plus I'd imagine there are a fair few like me who just can't imagine themselves in any other career. Though I must say I'm more likely to quit medicine than leave the UK, but I genuinely don't know what I'd do if I wasn't a medic so I'll stick with it for now!

Reply 7

ghanglish

16

Just out of interest, how common/easy is it for british doctors to work in another part of europe (e.g. Holland, Belgium) assuming they know the language of course.

Reply 8

digitalis

17

I know everyone says "I want to help people"

Instant application into bin.

Reply 9

Renal

17

ghanglish

Just out of interest, how common/easy is it for british doctors to work in another part of europe (e.g. Holland, Belgium) assuming they know the language of course.

In theory, it's relatively easy. But I don't know of anyone who has even tried to do it.

Reply 10

crazyhelicopter

11

ghanglish

Just out of interest, how common/easy is it for british doctors to work in another part of europe (e.g. Holland, Belgium) assuming they know the language of course.

They were advertising in the sBMJ a while back for FY1-2 to go and work in Germany- they pay for you to learn the language and there is less **** there (not their exact words but still)

Reply 11

Huw Davies

11

Helenia

Of my year, all but one (I think) are going onto the foundation programme. As for where we'll go later, I don't know. A few have started taking the USMLE, but most of us wouldn't go near the States. There are also a few considering doing their F2 in Australia/NZ, and some of them may not come back.

How practical is it to change countries during Foundation? Does it hurt your ability to come back for ST?

Reply 12

Helenia

20

Huw Davies

How practical is it to change countries during Foundation? Does it hurt your ability to come back for ST?

As I understand it, if you go to the right countries (i.e. one with similar training structure to ours) you can do your F2 year out there, apply for ST back here and go straight back into it as normal. Not sure whether it would influence your ST application or not, and of course there are practical issues about being able to go for interviews etc, but it wouldn't be a major career no-no to do it, I think.

Reply 13

Renal

17

Huw Davies

How practical is it to change countries during Foundation? Does it hurt your ability to come back for ST?

The official word is that it's no problem doing your F1 overseas if you're foreign or your F2 overseas provided you can get wherever you're working to provide the equivalent training. However, I honestly have no idea how you'd get a job as an F1 anywhere outside the NHS.

Reply 14

AEH

8

To the OP. The great big MTAS mess-up of a few years ago has largely passed and they've managed to run the system for Foundation applications a few times now without anyone egging the health secretary. There doesn't seem to be much will around to change things either way now and Patricia Hewitt (The health secretary at the time) got stuffed when Brown took over as PM and has now decided to leave Parliament altogether (A little dance was done by myself this week at least).

In the long term, there are still massive worries about the profession is going to look in twenty years. There is an element of de-skilling and down-grading of doctors and there's big gaps where people just haven't thought about training in a logical way From personal experience, if hospitals don't let students do practical blood work, exactly how is it they expect them as house officers to have magic powers when they're bleeped by other people after failed attempts two years later? This kind of pattern is being repeated a hundred different times. At the same time, medicine is having to cope with being challenged from the outside for the first time in a very long time, from patients, from the government, from other professions and from the media. Some of this is a natural correction of the unfair protection we were given for many years, some of this is people just having a dig at doctors for whatever reason and some of it is the profession feeling hyper-sensitive in having to deal with criticism for the first time in their working lives.

Finally, again with a bit of a personal slant, there are parts of the new training table that have clearly been designed from a simple workforce management perspective and have no regard whatsoever for how people actually live their lives. For example, it is quite possible that I now have all the experience I'm going to get in O&G before I commit an application to their ST run-through program. Yes, I will hopefully get an F2 rotation in it secured during my final year but I will at best have recently completed that job with weeks to go before I actually apply to the RCOG and at worst be applying to the RCOG before I actually do the job as a doctor rather than a medical student. Given the commitment of time and energy on both sides in Specialist Training, this is a fairly surreal situation.

Reply 15

DhobyGhaut

OP

9

Thanks for the replies. I'll go away and have a long hard think then.

Reply 16

ledleyking123

12

Out of pure interest, what is exactly happening, is there simply a lack of jobs in the profession?

Reply 17

Renal

17

ledleyking123

Out of pure interest, what is exactly happening, is there simply a lack of jobs in the profession?

It's far more complicated than that.

There's a reduction in training. There's the introduction of the 'junior consultant' level. There's the reduction in career exposure. There's the reduction in career choice. There is a lack of jobs in certain specialities at certain levels and over the next decade that's going to get much worse.

Reply 18

ledleyking123

12

so you are saying after 5 years medical school and 2 years training, it's a poor outlook for doctors in the UK?

Can you expand on how there is a reduction in career exposure?

Reply 19

crazyhelicopter

11

ledleyking123

so you are saying after 5 years medical school and 2 years training, it's a poor outlook for doctors in the UK?

That rather depends on the individual. If you don't care about your speciality, training or where you live, there isn't really much of a problem.

If you for example want to do a competative speciality, in a non staff grade job,or want to work in a set area of the country things get more tricky.

Can you expand on how there is a reduction in career exposure?

As I understand it the reduction in junior doctors hours means you have less exposure during the first few years. This is combined with upskilling of nurses and the use of PAs, meaning junior doctors do fewer hands on procedures and are thus less competent.

As an example...

FY1 doctors were previously responsible for cannulations. In some hospitals you now have physicians assistants who do the cannulas. Now doctor is only called for the difficult patients, doctor has less experience of simple cannulas and is thus less able to deal with this etc

As you get higher up, with the invention of junior consultants, this is repeated further- consultants have had less patient exposure during their training and so are less well trained and prepared for difficult stuff when it comes to them.

Would you rather be operated on by the consultant surgeon who has done 400 operations of this type, or the junior consultant who has done far less.

Admittedly I don't think it is as simple as this

Modernising Medical Careers - The Current Situation

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