[GCW]

Bloody physicians

[Tommy]

I also know someone who's not been shortlisted for ST1  - despite putting loads of effort into doing specialist work related things over the years and being one of the first in year to pass MCRPart 1. You don't even get an "offical no" - just a hear nothing in the post and presume. Utter load of shit. What's wrong with Sheffield?!!

[uptown]

Hospital medicine eh? Should've gone down the mrcgp route - I hear they work too few hours in poly tunnels for too much money. Now where's that spin smiley??

[fatdoc]

i'm sorry for you saltbeef.

i kept living in sheff whilst training, but commuting to leeds. with shift patterns that's not feasible.

consider abroad. if I had my time again i'd not be here.

you could end up anywhere at the end of your training, remember this is only the training bit of the career... the real work honestly starts with consultant appt. This is often overlooked (and was by me) by trainees... by getting in to a rare (ish) and cool speciality you close down a lot of geographical oppertunities.

By 35, consultant, busy busy life... travelling more than 45 mins a to crag comes a real time managemnt issue. Look at the power of climbing thread - those that still do live close to the area they are still known to climb in.

manc and leeds are of course fine, esp leeds IMO. But if the chance of the longterm job at the end of it all is slight in the sheff / leeds / manc triangle i'd consider a rethink....

fucking depressing shite this, i'm agreeing with the government fucking it all up posts on here.....


Sidney?

[saltbeef]

sydney is definitely on the agenda. they have a very pro active cardiology dept plus a beach and climbing in the city/blue mountains....
gcw, surgeons are uncoupled too. anything worth doing is uncoupled...

gp. think of it. same little room, same depressed middle aged women and people with all over body pain, anything interresting you refer... doesn't bear thinking about. plus where are all these gps gonna work?!

[uptown]

fucking depressing shite this, i'm agreeing with the government fucking it all up posts on here.....

GP contract poll from the BMA this morning - I wonder what most GPs will answer to the following questions?

Do you believe that the Governments' method of negotiation is acceptable or not?

Do you believe that the direction of government policy (in England) to expand private commercial provision of NHS general practice will be: ...detrimental to patients and the service as a whole?

How confident are you in this government's handling of the NHS?



I wonder just how broken the NHS really was to warrant the spin and fix this present government has felt necessary to impart???

I feel for you Saltbeef but you'd be welcome in Leeds.

[GCW]

gcw, surgeons are uncoupled too. anything worth doing is uncoupled...

Sorry, cheap surgeon vs medic pop.

This is what we’ve been told by our Head of Training (Surgical side admittedly):

If you are in a CT post at present you should be fine.
If you are in a FTSTA post you probably won’t get an ST3 job.
If you are not in CT/FTSTA job by August you may as well resign yourself to Article 14, as you have little chance of getting into training.
CT trainees will always be given priority over everyone else- this is necessary to make the system work.

The selection process has now changed towards the ST system, therefore experience in a specialty goes against you.  Anything over 12 months in a speciality will be penalised heavily at all stages of entry.

Once in ST3 and above, you can expect to finish with a CCT, although some later posts may be converted to programmes that finish at ST6.  These guys will be unable to do elective work, and will essentially end up covering trauma.  If they wish to move into elective work they will need to do a 2 year fellowship.
When you finish at ST8 with a CCT your experience will the less than the old SpR6.  You will therefore enter a sub-consultant post which will basically be the equivalent of the old SR system.  You will do most of the donkeywork, mostly trauma and on calls (which will be resident).  There will be a bottleneck from here to True Consultant jobs, like there always used to be.

Because of the EWTD 2009 changes, it is likely ST trainees will reduce their on calls (or stop altogether).  One  on call in the week leads to a loss of over one day’s training, which the STC is keen to avoid.  These on call duties will shift to all those doing article 14 or career posts.

Essentially you end up with:
An ST system where you get stuck at a sub-consultant post, doing trauma and resident on calls.
A career grade system where you do all the non-educational duties and most of the on calls.  If you manage to pass your exit exam and get a CCT, you will still be considered below an ST trainee for any sub-consultant jobs.

Foundation doctors will be more protected, so work will move up the levels.  Shitty ward work will become job of the ST1/ careers grades, acute admissions  likely the careers grade middle grades/ maybe ST3+.


People who are finishing a Reg level research job  on August are truly fucked.  We are now aware we are highly unlikely to enter training and are competing for very, very few jobs that are all primarily for ST/CT guys.  OK, the new system has to be forced to work but it still pisses a lot of people off.  Many people, me included, are thinking strongly about dumping 8 years of training and doing something else.  if that happens, fuck knows what will happen to the NHS- most of the graft will have to be done by experienced career grades, if any remain in the system.  I’m thinking it may be time to get out before it gets even worse, which it will- mark my words.


Whinge over

[Fatleg]

I'm probably leaving the NHS. Just starting to plan the exit route, and I'll sit on the sidelines and watch the whole thing collapse. The only people who will be okay in my view will be ST trainees on run through numbers providing they pass exams /ritas etc. They may well have to become a 'sub-consultant' - but eventually they will move out of that grade, I expect it will take around 7 years (remember the government wanting to stop private work by consultants for 7 years). GPs will probably be okay - alright there may be alot of them but a large number of GPs from India etc are due to retire in the next few years so there will be work for these trainees, and I expect GP will go private - much like dentistry.

[webbo]

slightly off topic but picking up on the retirement angle.in my mental health trust 50% of the nursing staff are eligible to retire in 5 years time and its supposed to similar in most trusts.
time bomb or what.

[fatdoc]

gcw, surgeons are uncoupled too. anything worth doing is uncoupled...

Sorry, cheap surgeon vs medic pop.

This is what we’ve been told by our Head of Training (Surgical side admittedly):

If you are in a CT post at present you should be fine.
If you are in a FTSTA post you probably won’t get an ST3 job.
If you are not in CT/FTSTA job by August you may as well resign yourself to Article 14, as you have little chance of getting into training.
CT trainees will always be given priority over everyone else- this is necessary to make the system work.

The selection process has now changed towards the ST system, therefore experience in a specialty goes against you.  Anything over 12 months in a speciality will be penalised heavily at all stages of entry.

Once in ST3 and above, you can expect to finish with a CCT, although some later posts may be converted to programmes that finish at ST6.  These guys will be unable to do elective work, and will essentially end up covering trauma.  If they wish to move into elective work they will need to do a 2 year fellowship.
When you finish at ST8 with a CCT your experience will the less than the old SpR6.  You will therefore enter a sub-consultant post which will basically be the equivalent of the old SR system.  You will do most of the donkeywork, mostly trauma and on calls (which will be resident).  There will be a bottleneck from here to True Consultant jobs, like there always used to be.

Because of the EWTD 2009 changes, it is likely ST trainees will reduce their on calls (or stop altogether).  One  on call in the week leads to a loss of over one day’s training, which the STC is keen to avoid.  These on call duties will shift to all those doing article 14 or career posts.

Essentially you end up with:
An ST system where you get stuck at a sub-consultant post, doing trauma and resident on calls.
A career grade system where you do all the non-educational duties and most of the on calls.  If you manage to pass your exit exam and get a CCT, you will still be considered below an ST trainee for any sub-consultant jobs.

Foundation doctors will be more protected, so work will move up the levels.  Shitty ward work will become job of the ST1/ careers grades, acute admissions  likely the careers grade middle grades/ maybe ST3+.


People who are finishing a Reg level research job  on August are truly fucked.  We are now aware we are highly unlikely to enter training and are competing for very, very few jobs that are all primarily for ST/CT guys.  OK, the new system has to be forced to work but it still pisses a lot of people off.  Many people, me included, are thinking strongly about dumping 8 years of training and doing something else.  if that happens, fuck knows what will happen to the NHS- most of the graft will have to be done by experienced career grades, if any remain in the system.  I’m thinking it may be time to get out before it gets even worse, which it will- mark my words.


Whinge over

that's the best synopsis of all this I've ever read.

1. post on drs.net

2. start looking at jobs in the media

waddage.

[duncan]

should've done dentistry.

You are joking I hope...

Glass half-full: you've been offered three different jobs of exactly the kind you want, if I understand correctly, all in excellent climbers cities. 

Compare your lot with the 70% of 2006 physiotherapy graduates who were not working as physiotherapists six months after qualifying.  Ever wondered why there are waiting lists to see an NHS physiotherapist?

[duncan]

should've done dentistry.

You are joking I hope...

Glass half-full: you've been offered three different jobs of exactly the kind you want, if I understand correctly, all in excellent climbers cities. 

Compare your lot with the 70% of 2006 physiotherapy graduates who were not working as physiotherapists six months after qualifying.  Ever wondered why it's so hard to see an NHS physiotherapist?

[saltbeef]

yeah, i can't imagine looking in people's fungating mouths for a living.

the main reason why i'm getting shortlisted is because i've made it harder to not short list me, by working hard.  that means audit, courses paid for out of my own pocket, and doing postgrad exams to a level beyond which is expected.
i do feel sorry for physios, why are they traiining them if there are no jobs. i do know some people who are physios though recently trained and have got jobs in stuff they want where they want them, not the usual granny dragging.

the main thrust of my whinge is i'm a sheffield graduate, i've worked here for 2 years and i'm getting shortlisted elsewhere, but i'm not getting shortlisted where i got trained and that leaves a sour taste and a slight lack of loyalty. anyway whinge over, ive got my head round moving and i'll hopefully have a job this time next week.

[Bubba]

gp. think of it. same little room, same depressed middle aged women and people with all over body pain, anything interresting you refer... doesn't bear thinking about.

Just sit back and think of the 100k

[duncan]

i do feel sorry for physios, why are they traiining them if there are no jobs. i do know some people who are physios though recently trained and have got jobs in stuff they want where they want them, not the usual granny dragging.

Historically, there was a lot of competition to get onto physio. courses but you could walk into a job at the end, much like medicine.  8 years ago, whoever dictates these things decided the NHS needed more physios.  Physiotherapy gets people back to work and (later) keeps them out of care homes, both of which are huge money-savers for HMG.  So from around 2000 the number of training places was increased by 60% in three years.  The amount of money going into the NHS has increased similarly.  So far so good…

Unfortunately, not much of the extra NHS cash seems to have come the way of physiotherapy.  I’ll leave you to speculate where it has gone.  The end result has been far more new physio. graduates chasing much the same number of jobs as before.  An employment version of the “credit crunch” ensued with no-one in a job daring to leave which just made matters worse. 

The numbers graduating peaked with the class of 2006 and are now falling.  School leavers are wise to the job situation and general sense of chaos in the health service and are not applying to health professions (not just physiotherapy) in anything like the numbers they were.  Can you blame them?  Ironically, by the time someone starting in 2008 graduates, the job situation will probably be much better and there might even be staff shortages again…     

[saltbeef]

i would recommend medicine cos its great fun. but you have to deal with this shit. so i'd fuck off to australia

[Houdini]

This is an interesting thread w/ so much more than Beef's beef.


Seriously, isn't it time that the NHS changed?  Not just some twerp in a suit saying This trust will be taking a radical change in direction for the financial year 08-09  blah.  But to a fully health insurance funded system for everyone (which a skeleton service existing simply for those that cannot afford health insurance)? 

The Frau sees her doctor on Monday evening complaining of headaches at work ~ Wednesday morning she is having  a CAT scan.  She pays her way and gets everything she needs extremely quickly.  We all know the  NHS is a dinosaur, isn't it time we put it to bed?  Why is Britain so far behind Europe in so many things?

 

[Jaspersharpe]

Impossible to implement. What about the implications for National Insurance contributions for starters? The idea is that we all pay for healthcare / pensions in this way. The reality is that they are now just another tax and it all goes into the same pot but that's not the point. This is obviously just the tip of the logistical and political nightmare. Unfortunately.

[GCW]

One of the main issues at the moment is morale.  A lot of people are pissed off because they get no respect and get mucked about all the time.  Goalposts change regularly, meaning noone is ever sure what is going on.  I'm not convinced this is accidental, or maybe I'm getting too cynical.  Ulterior motive says my guts.  I have a suspicion someone is attempting to disempower doctors- it's already happening with manager deciding what we do on operating lists (we have little say) or where someone is sent for surgery (this varies depending on waiting lists).

Bubba, these changes are a good way of pushing through new contracts for GPs/ consultants etc, and once you get there you won't have any choice but bend over.

[grumpycrumpy]

Jesus , what a bunch of moaning minnies ...... I live in Sheffield and the ONLY job that's come up in my line of work  in the last five years was deputy workshop manager at The Crucible .... Pay was a criminally low £5.84 an hour with no overtime till you'd worked 160 hours in that month ..... And I spent three years training at college , and have worked in the industry for nye on twenty years ......

[Jaspersharpe]

I'm not convinced this is accidental, or maybe I'm getting too cynical.  Ulterior motive says my guts.  I have a suspicion someone is attempting to disempower doctors

Who and more importantly why though? It sounds like the situation is being royally fucked up but who will this benefit?

[Fatleg]

The government either wants to privatise the NHS - vote loser, so probably not going to happen.
Or reduce doctor power and shift it no the managers or Whitehall. HRM basically fucked up the consultants / GP pay deal, thinking they all did no work and played golf all hours or were at the St Elsewhere earning a load of cash. The truth is consultants go way above and beyond the call of duty and do their sessions and alot more - this lead to their large pay rises of the past few years. The DoH has now decided to reign in the pay and the only way to do this is to prevent everyone becoming a consultant and creating tiers of doctors that are partially trained to provide the ever increasing amount of service work. The few consultants will have a similar role to now, but in much smaller numbers. This may just be market forces at work with only the best / survivors getting to the top, the problem is that the people who's careers are getting fucked up are in the top 1-2% of school & university leavers who won't accept being shafted. In the past you churned the work out as a junior dr knowing there was an exit at the top, now many won't get there and will proabably decide to leave medicine. Rant over.

[Jaspersharpe]

Interesting shit. Ta.

[fatdoc]

Jesus , what a bunch of moaning minnies ...... I live in Sheffield and the ONLY job that's come up in my line of work  in the last five years was deputy workshop manager at The Crucible .... Pay was a criminally low £5.84 an hour with no overtime till you'd worked 160 hours in that month ..... And I spent three years training at college , and have worked in the industry for nye on twenty years ......

Look at what is being said here with respect to the change in workforce in the NHS by way of a cyclical error in training numbers and then jobs for Drs, physios and nurses to go into...

The disempowerment of the professional classes as a whole is one other issue I too give creedance to HMG. Drs at the mo.. they failed with the law.. who knows the future...

Look at swathes of expensively traineed drs leaving the country in droves due to a selection process for training posts so fucked up that consultants have no choice who works for them, what grade they will be and the junior dr in question may not even want to be in the speciality.

This thread is not about earnings, if earnings were a prime mover in your choice of career then I'm sorry you never *made* it. I guess there might at one time have been a true personal desire to take employment in that line of work - which prompted your career choice... somewhat like all the healthcare workers in this thread.. who are now fucked of with all the changing goalposts, HMG meddling and totally unfair selection processes.

Go moan about being poor somewhere else, you've missed the point.

[fatdoc]

i would recommend medicine cos its great fun. but you have to deal with this shit. so i'd fuck off to australia

my point exactly... and I've read his CV. Its top class.