NHS Part 1 - Modernising Medical Careers
I've decided to write about my general dissatisfaction with the NHS and the medical profession. So, this blog is about "Modernising Medical Careers", or MMC for short. But first, a little intro...
MMC is a new initiative that has been in the works for a few years now. The idea was to re-organise and streamline post-graduate medical training into an efficient system where doctors would gain a good grounding in medicine and surgery, before entering specialist training schemes designed to take them all the way to "Consultant" grade.
Currently, after graduation you spend 2 years in a new "Foundation Programme" (replacing the old Pre-Registration House Officer (PRHO), and first year of Senior House Officer (SHO) grades), spending 4 month rotations in medicine, surgery, and various specialities. Then you enter either SHO posts for speciality training, or pilots of the new "Specialist Training" (ST) programmes, due to go into full flow in 2007.
The problems? Well......
Instead of having a good deal of medicine and surgery experience after the first 2 years, some people are walking away with a minimal amount of medical and surgical experience, having spent the rest of the time doing something like General Practice, or Obstetrics & Gynaecology. Fortunately, not everyone has this nightmare, and so for the most part, juniors are getting a decent grounding - just about.
From 2007, the SHO grade is supposed to be (for all intents and purposes) abolished, as the new ST run-through programmes enter "full-release" from "beta testing" this year. But there's a problem....Noone's decided how current SHO's will feed into the new programme. They can't enter from ST1, because they've had more training (generally) than those finishing Foundation Year 2 (FY2), and they haven't completed a FY2 year (unless they were lucky enough to have done a pilot in the last 1-2 years), so they aren't eligible to apply anyway. This means that somewhere in the region of 20,000 SHO's are going to have to fight for entry into ST2 and ST3 (ST3 being where Registrar training will "begin" in the new system) years. However, with waaay more SHO's than ST posts and National Training Numbers (NTN's - Required to ensure Registrar training "counts" officially), this is going to cause a lot of problems. Add in the fact that noone has decided how people get sorted into where, and you start to realise the extent of the problem that is looming on the horizon.
If you're unlucky (ie: in the majority), and don't end up with a ST post, then you're going to have to fight with everyone else for the last few remaining SHO speciality posts around, which are only going to be 6 month posts as far as we can tell, so job security is crap, and you're going to be looking for the "next job" almost as soon as you start the one you just got.
Just as they can't decide how SHO's will feed in, they haven't decided how FY2's will feed into ST1. At least, not in detail. They state that people will be shortlisted based on whether they have have achieved FY competencies, but considering that you will have finished a FY2 post (and therefore said competencies have been achieved), this means very little. Individual Royal Colleges have little or no clue how they will cut down the competition at the "interview" stage, considering tha pretty much everyone who applies will probably meet the criteria for shortlisting. In the past this would be done through assessment of experience in audits, presentations, and research, but this is no longer allowed (at least for initial shortlisting, and perhaps at "interview").....
MMC is a new initiative that has been in the works for a few years now. The idea was to re-organise and streamline post-graduate medical training into an efficient system where doctors would gain a good grounding in medicine and surgery, before entering specialist training schemes designed to take them all the way to "Consultant" grade.
Currently, after graduation you spend 2 years in a new "Foundation Programme" (replacing the old Pre-Registration House Officer (PRHO), and first year of Senior House Officer (SHO) grades), spending 4 month rotations in medicine, surgery, and various specialities. Then you enter either SHO posts for speciality training, or pilots of the new "Specialist Training" (ST) programmes, due to go into full flow in 2007.
The problems? Well......
Instead of having a good deal of medicine and surgery experience after the first 2 years, some people are walking away with a minimal amount of medical and surgical experience, having spent the rest of the time doing something like General Practice, or Obstetrics & Gynaecology. Fortunately, not everyone has this nightmare, and so for the most part, juniors are getting a decent grounding - just about.
From 2007, the SHO grade is supposed to be (for all intents and purposes) abolished, as the new ST run-through programmes enter "full-release" from "beta testing" this year. But there's a problem....Noone's decided how current SHO's will feed into the new programme. They can't enter from ST1, because they've had more training (generally) than those finishing Foundation Year 2 (FY2), and they haven't completed a FY2 year (unless they were lucky enough to have done a pilot in the last 1-2 years), so they aren't eligible to apply anyway. This means that somewhere in the region of 20,000 SHO's are going to have to fight for entry into ST2 and ST3 (ST3 being where Registrar training will "begin" in the new system) years. However, with waaay more SHO's than ST posts and National Training Numbers (NTN's - Required to ensure Registrar training "counts" officially), this is going to cause a lot of problems. Add in the fact that noone has decided how people get sorted into where, and you start to realise the extent of the problem that is looming on the horizon.
If you're unlucky (ie: in the majority), and don't end up with a ST post, then you're going to have to fight with everyone else for the last few remaining SHO speciality posts around, which are only going to be 6 month posts as far as we can tell, so job security is crap, and you're going to be looking for the "next job" almost as soon as you start the one you just got.
Just as they can't decide how SHO's will feed in, they haven't decided how FY2's will feed into ST1. At least, not in detail. They state that people will be shortlisted based on whether they have have achieved FY competencies, but considering that you will have finished a FY2 post (and therefore said competencies have been achieved), this means very little. Individual Royal Colleges have little or no clue how they will cut down the competition at the "interview" stage, considering tha pretty much everyone who applies will probably meet the criteria for shortlisting. In the past this would be done through assessment of experience in audits, presentations, and research, but this is no longer allowed (at least for initial shortlisting, and perhaps at "interview").....
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