Just a Trainee Consultant Academic F2 Doctor
Just a Dentist, prev OMFS
BMA LNC š¦
Advanced Pastry Practitioner
Parody RCGP Foodie Fellow
Cat slave š»
Medicine is unfortunately going the same way as dentistry. You think a private root canal is expensive? Wait until you see the cost of a knee replacement
Just in case anyone was in doubt, this is why there is a doctors strike today. Itās not greed. Their dedication to service has been exploited by government and finally itās gone too far.
If you want to see what happens if this isnāt sorted just look at dentistry in the NHS!
āYou know what you signed up forā
A few things med students defo DIDNāT sign up for:
- Random job allocation for FY
- No acknowledgement of academic achievements
- Essentially random job allocation for most specialties (MSRA)
- Lack of job security w/worsening ratios
/1
A difficult convo at work reinforced how much of a problem this is.
I met a close friend of the late Emily Chesterton last night; she was telling me she no longer trusts GPs because of what happened. She thought a PA is a ājunior GPā because the word āPhysicianā means dr right?
Weāve always known this was the plan. From physician assistant to physician associate, and from physician associate to medical associate professions, and then to medical professionals.
All a game of deception and manipulation.
Questions:
Should med students with a PhD introduce themselves as āDrā on placement?
Should qualified dentists at med school call themselves āDrā on placements?
Should doctors studying dentistry introduce themselves as āDrā when seeing pts as a dental student?
If not, why?
First day on GP today, and being right on brand I took them some of my bakes to introduce myself :)
Pistachio bundt + pain au chocolat went down v well!
@glambystefania
@manLikeTeaa
@SecretPhysician
Stefania if I were you Iād have a think about what youāre posting. Youāve admitted to doing some things out of your scope (suspending meds, solo WR) + are adding fuel to a raging fire. Either youāve done these things, or trying to aggrandise which is misleading + unprofessional
@medicalmodelbri
Doctors only know about one specialty, whilst they know a bit of all the specialties? Is that a joke?
Medical registrars, how many specialties have you rotated through now? At least 13 Iām guessing.
Heather makes an interesting point. Much of what is in the recommended scope is a large part of the day job of FY and core doctors.
So if thatās too basic for someone with a PA qualification, how is it appropriate for someone with a medical degree + PG medical training + exams?
But this document is not going to fill that gap - it's too far in the opposite direction. That scope does not require a UG degree and a post-grad with life-long CPD
@RodricJenkin
Politely disagree Dr Jenkin. Doctors have gotten into a mindset of not celebrating successes + downplaying our achievements.
Morale is extremely low, every win should be celebrated.
+ Yes, the recruitment process is pants.
Iāve heard many consultants complaining about how FY doctors & med students arenāt āas good as they used to be back in the dayā.
I love pointing out itās not people of my generation that designed the current med school curricula or PG training programmesā¦
@thomaswoodcock
@TheBMA
I will not be one of them. Year in year out, the workforce complain about less skilled junior doctors joining a department. Well perhaps if you offered these training opportunities to them instead of PAs, this wouldnāt be the case.
@SecretPhysician
@john_brittenden
@DrEilidhMaria
My main takeaways from it were that bottlenecks will continue to increase, they will continue to expand the scope of MAPs + they are essentially our equivalents.
āMy taxes pay for your trainingā
A frequent comment I keep seeing, especially with strikes.
We already knew, but here it is from the Medical Schools Council themselves that the tariff isnāt invested into students training!
Yet more money disappearing into a holeā¦
Nicked from
@MedReddit
now weāve got 2400:1 competition ratios for LED posts!
For those of us preparing for unemployment in Aug, any suggestions? Itās becoming very hard to push through a terrible ED rota with all of this looming.
Shall I go rogue + do a baking internship?
Me going to Pharmacy: Hi please can I have some cipro for my perichondritis?
Pharm: No thatās not on our list, see a dr
Me: I am a dr, hereās my symptoms + swollen ear.
Pharm: Nope.
But how are they giving abx for other infections that arenāt as obv as my swollen ear š¤
First full day on GP.
All I will say is seeing undifferentiated pts w/out quick access to investigations is really fucking hard (as a trainee anyways!) + those making light of this/thinking a couple yrs education is adequate are even more nuts than I originally thought.
18K out of my own pocket and a 20K paycut to become a doctor.
A lot of people have been sold a lemon by these wild new plans, but to my OMFS colleagues- weāve really been effed. Nil funding, no pay protection, working ridiculous hours alongside the medical degree.
I have removed my earlier posts at the request of the persons involved as they have been receiving death threats + other disgraceful messages on IG. They have altered their website bios now.
Whilst some of their language was inappropriate, it absolutely didnāt warrant threatsā¦
As Iāve paid my final prof cost of 2023, hereās the round-up!
GMC Ā£166
DEMEC Ā£320
FAMUS Ā£100 (400 funded)
PGCert Ā£3K
MSRA qu bank: Ā£85
GDC: Ā£621
Indemnity Ā£1K
ATLS Ā£550
Earnings (inc locum) pre-tax: ~40K
Ā£1.6K dental- but w/out this work option I couldnāt afford the rest!
@DrNeenaJha
Had an F2 colleague tell me something similar, the PA would respond with āoh just call me Xā, thereby effectively confirming they were a doctor.
Also heard of nurse associates introducing themselves as āone of the nursesā. I wonder if RNs take issue with that?
There is a distinct difference in tone in how nurses raising concerns about NAs is received, vs doctors concerns over PAs.
Why arenāt the nursing profession welcoming these new ways of working, diversifying the profession + skills mixes? Isnāt there enough work for everyone?
Can the employer who created this title please explain what a District Nursing Associate is & scope of their role? A District Nurse qualification is postgraduate, releflecting an advanced level of practice. It is for RNs only & regulated by
@nmcnews
@alisonleary1
@johnunsworth10
@bmj_latest
@aneezesmail
Apprenticeships are another way to exploit vulnerable students from WP BG +trap them in UK. Also, the article states unis spend too long on basic sciences! These are fundamentals upon which our clinical knowledge+ decision-making is built upon. Lowering stds is not the way fwd
- Possible unemployment due to lack of NTNs + JCFs
- Pay suppression
- Inc professional costs + āpay for progressionā on top of suppressed pay
- Inc interest on student loans
- If you can get one, redistribution of NTNs further dragging you away from support systems
/2
Interesting convo with a colleague last night- sheās leaving nursing + retraining as a quantity surveyor. Theyāre paying a similar salary to B6 (as a trainee), + they fund her masters + pay all expenses.
The exodus of HCPs continues, + UK healthcare is going down the drain.
And 10 years later, the IMT doctors in my region still have to organise their own teaching.
āTraining programmeā is a generous use of the term here.
training I had no issues with - I even taught on it myself, but it paled hugely to the CMT program that we had to self organise - it frequently became an hour of bleep free ranting about how unfair the current set up was.
Ofc, our concerns were raised at LFG meetings and some
@jabberwock951
No they canāt; Iām dual-qualified as a doctor and dentist + canāt just use my medical license to start treating my dental pts for medical issues. They wonāt be indemnified for it either. Dr Siau has just gotten the PA into some trouble with that post I imagine
@dgfull
@Jo_McGinn
@AlisonGeorge10
@veggieequallife
@Dr_Done_
@BMA_James_Steen
Dr Fullerton, are you able to answer why PAs are able to reach SpR-level roles + opportunities much faster than drs, without same requirements such as exams/portfolio etc? Do you think drs dissatisfaction with the double standard can be explained with the āelitismā claim solely?
@hayleymagill
Itās awful you were treated that way. Iām glad you had the strength to leave; I almost handed my notice in last yr when I was bullied but didnāt have the guts. Hope youāve moved onto better things + have a healthier work life!
- Having to āsuperviseā non-drs, even as an F1
- Being trapped on training programmes making you even more susceptible to bullying + harassment
- Worsening access to training opportunities + taskification of medicine
- Bungled recruitment processes at every step
/3
@weeinstillag3l
@ConkerLover
@Dr_Done_
I like to consider myself the F1 Rottweiler. No one gets to be mean or rude to āmyā F1s. Iām a permanent staff member, I donāt rotate, and I know who to escalate to when people pull āthatās not my jobā and dump everything on the F1. Not on my watch. š
@dr_shibley
@LBC
Dental associates are actually qualified dentists working in practices, but do not have a partnership. A bit like associates in law. Itās why physician associate as a term in itself is confusing when compared to other professions.
The title is deliberately obfuscating the role, driven by the GMC, health bodies + gov.
Iāve pointed out many times associates in law + dental associates are fully qualified in those professions; the nomenclature doesnāt make sense.
This is a HCP who has been closely involved with the events following her friendās death. And until last night even she didnāt realise Emily hadnāt been seen by a dr. She didnāt understand what a PA was + I had to explain they do not have a medical degree/training + are not drs
@Ask_foradoctor
Iām glad they know what the names of the drugs are. Thatāll be useful when theyāre asking the F1 to prescribe for them next year.
Seems as though many are finding it easy to dismiss the concerns of current/future FYs over their recruitment + training just because theyāre the most junior.
Can I remind you of the nomenclature? Itās called the FOUNDATION programme.
Would you build your house on noodles?
@zackferguson
Arenāt you missing the point? Your anecdotal experience doesnāt mirror the experiences of your juniors, or of those around the country. People are unhappy the standards weāre held to as drs are not the same for those in other areas, but yet they do our jobs? Doesnāt make sense.
Just to say š
These came yesterday
via
@DrPastry
Combinations of Hazelnut praline; Jaffa biscuit; Pistachio & Orange blossom ā¦
Absolutely exquisite taste- what a talent indeed
Love to see this entrepreneurial side
Wonderful š„°
#NomNom
Many say there is āenough work to go aroundā; it needs to be the appropriate type of work for that person.
An IMT/CST/FY dr is a future senior in that area + needs to be competent in procedures so they can perform them independently out of hrs + teach the next generation.
The best solution to this mess Iāve seen: implement a āright of first refusalā
If thereās a procedure to do, the Drs are offered it first. If they donāt want/donāt need to do it, send it to the PA
Even better, scrap rotational training, the real culprit
@LeylsTurk
On my TAB someone wrote that theyād trust me to look after their own family members! Thatās the greatest compliment Iāve ever had (professionally)
1/ Med + surg training are terrible. The best surgical training I received was as an OMFS dental core trainee. Look at my old rota; I wonder how many CSTs/IMTs get so much procedure + clinic time?
Dentists get better surgical training than drsā¦ Madness!
Doctors are fed up.
PA in theatre doing the doctorās job, then bossing the doctor about via a nurse.
Despicable. Our roles and achievements have been hijacked, and we need to start claiming them back.
ā ļø ā ļø ā ļø
@ollieburtonmed
I think we should flip this around. If a PA can do it, why not a doctor? Iāll take my ST3 post, endoscopy training and daily 9-5 clinic job now please!
@veggieequallife
All HCP degrees study some med sciences. But āMedicineā is a GMC-regulated degree leading to a specific qualification. I had 2 yrs of medical-related teaching in dentistry. I did not study medicine. Other HCPS donāt claim this. Why is it so difficult for some PAs to understand?
Billionaire tells normal people to get back to work, and stop being sad about issues seriously affecting their health his political party have purposefully caused (and ignored).
GPās will soon be stripped of the ability to sign people off work as part of a major government inititive to crack down on āsick note cultureā
Rishi Sunak says people should stop 'over-medicalising the everyday challenges and worries of life'
@quackophage
So this person is pretending to be both a doctor + a dentist now.
I keep thinking we have reached the limits of ridiculousness, + every day Iām wrong.
Speaking with dentist apprentices in Bury, they told me about the staggering number of children they see with tooth decay.
Labour will change this with supervised tooth brushing in schools.
Healthy, happy children means lower NHS waiting lists and more people seen on time.
@gaswomancometh
I agree Rosie. I had to do medicine for OMFS, self-funded the degree completely and took a 20K paycut as an F1. I accept I made my decisions, but having a parallel profession that circumvents the sacrifices we make to prove competence doesnāt make sense.
@Cleverclog67596
This is vile. I canāt even imagine how hard the GDC/GMC would have come down on me (probs not GMC actually) if Iād have made reaction vids after I saw my first carotid blowouts.
Unprofessional, but also makes you wonder of the bizarre mindset these people have
@DrPJJB
Your use of the word apprentice is rather disingenuous, as most junior doctors work independently running a service. Thatās not quite the same as an apprentice in other fields is it?
@gmcuk
@HullYorkMed
Please stop insulting our intelligence with claims of āmisunderstanding rolesā, like weāre somehow confused.
You are the oneās misunderstanding in this situation.
Apparently from
@gmcuk
all āevidenceā on PA effects on dr training is positive. Given the changes in roles + scope, is it wise to hang on to this āevidenceā? Anyone else picked up any issues with the quality of this āevidenceā?
Doing med school interviews today.
The temptation to scream āRUNNNNN! GO AND DO SOMETHING ELSE!ā at these bright folk was extremely difficult to resist šš
Foundation doctors deserve equitable access to training opportunities. You have the knowledge + abilities to do more than ward ātasksā.
Changing peopleās mindsets on this is tough. Will I manage? Time will tell, but know that some of us will always fight the odds for you.
@caroll_ste87889
Happy to share screenshots from the various ones Iām in. Itās mostly āwhatās the code for this door?ā, ācan anyone cover this shiftā, āhow do you request xyzā
On the topic of regulatory duties, looking at how
@GDC_UK
work is v relevant here.
@gmcuk
state they can't challenge non-registrants behaviours, but GDC have prosecuted people for illegally practising dentistry. What's the point in a regulator if they won't protect the public? /1
š§µ We have written an open letter to the GMC setting out how its approach to the regulation of AAs and PAs blurs their distinction from doctors and constitutes a failure to fulfil its legal duties .... 1/n
@Xeon4f145d96s1
I still donāt understand what the point in locum PA posts is. Especially when theyāre paid more than a doctor?! Itās not even cheap labour.
@ClareGerada
@aashfaque14
@Cleverclog67596
@ExplosiveEnema2
@rcgp
But, 100% of F2s have experience as a DOCTOR already, so why donāt we have LED posts in GP if PAs can work in GP?
And yes I have worked with PAs, their systems + task-based knowledge is great. When it comes to clinical though, not so much although this is to be expected
@em_jenksPA
@DoctorPonglenis
Great, then seeing as youāre able to do many of the tasks we do youāll agree that your service provision role should include more of the admin that others can do? Which would free us up for more training opportunities?
@hannahmillana
I was told Iād never be a doctor or a dentist by my 6th form lead. And tbf I did totally bomb UKCAT and did biomed instead.
But now Iām dual qualified as a dentist and doctor mwahahaha
@Adam_Skeen
Dentists on the training pathway for OMFS (in England) are forced into a 20K paycut when starting F1, plus additional professional costs.
Nothing about doctorās pay makes sense.
@Xeon4f145d96s1
He doesnāt fit it anywhere on this scale. Heās not a dr. You donāt see drs included on other hierarchies for nursing, physio etc. This guy needs to get over his insecurities and accept his job role, or go to medical school.
@CJHamps
It's completely bizarre. Can you imagine if we were caught doing something like this ourselves by the GDC or GMC! They should be held to standards, regardless of lack of regulation (for now)
@askNasha
@SecretUrology
@Dr_Done_
@mphillips1996
Dunning-Kruger strikes again. Your experience of ST3s is likely quite narrow. Most ST3s I have worked with certainly donāt āstand thereā observing. Stating people have open contempt for PAs- you guys certainly donāt do yourselves any favours.
Excellent insights from
@Adam_Skeen
, thank you! It raised the recurring topic of supporting PAs through med school + if/how this should be done.
As someone who had to do medicine to cont progress in OMFS training, I have some conflicting thoughtsā¦ š§µ
@LittlePersonDoc
@RCPhysicians
Unlike many PAs Iām comfortable admitting I had always wanted to be a doctor. Due to circumstance (financial and geographical) I couldnāt. I became a PA.
Just weeks into the course I was dissatisfied with the deficiencies of the PA course. It wasnāt satisfying me academically
@ExplosiveEnema
@PApodcastUK
They didnāt know anything outside of eczema + psoriasis but are running derm clinics. Learning surgery from YouTube. Donāt these PAs see how theyāre giving themselves a bad name? But drs are being accused of smear campaigns. Theyāre smearing themselves!
SFP recruitment is being absorbed into the main allocation process from next year.
Lack of funding + investment in maintaining recruitment processes is just worsening the spiralling of standards in medicine
@LawrenceDunhill
@gmcuk
But these bad feelings, anxiety over going into work and being treated poorly have been held by many doctors for years. Nobody cares about our feelings? Why?
I left dental school at the bottom of my overdraft. Was advised by my dental tutor to avoid work as a HCA before starting my dental F1 in case something happened in HCA that would affect my dental reg. I was so scared each shift my career would be over before it started.
If a PA has not passed the national PANE exam and not registered on the PAMVR, are they allowed to work as a PA in primary care?
Should they be allowed?
Thereās definitely one example of this Iāve seen in the last few days
@Xeon4f145d96s1
Thereās more Pizza, one of them oversees care homes as the only āmedical professionalā. And a PA somewhere is doing elective surgery independentlyā¦
All things our Royal Colleges will be interested in of course
@LittlePersonDoc
@SecretPhysician
@john_brittenden
@DrEilidhMaria
Agreed Jenna. I brought up the OMFS training pathway as another example of scope ceiling + need for further education/training to progress. No response to that aspect ofc.
I still believe the standards are required for us to practice safely. But some donāt care apparently
@Xeon4f145d96s1
@JanetEastham
The mindset of these people is scary. What do you get out of illegal prescribing? A weird ego boost? The thrill of illegal activity at work? Wtf
@Dr_Done_
55K starting salary?! This is for a newly-qualified PA as well. No prior experience required. And the public is upset an actual doctor wants to earn at least 39?!
@LBC
@TomSwarbrick1
@TomSwarbrick1
great show. Unfortunately a couple of your callers proved concerns raised by drs- some PAs/ANPs/ACPs are not aware of differences in medical training +are confusing their abilities for certain tasks with the role of a dr.
@AnalysisDrawer
Many say that most PAs have a healthcare background, so whilst recruitment/ expansion is paused could they not work in their original field?
@iDrSunny
Consultants please correct me if Iām wrong, but doesnāt this change to defining SPA mean you could do 25% more clinical work for a 0-19% increase? Is this a sneaky paycut?!
@Adam_Skeen
Iāve always thought you all should be forming your own committee as part of the RCP and should be consulted on current events. You guys actually have that ādifferent perspectiveā everyone likes to talk about š
A pistachio cake commissioned for a birthday the other week!
Pistachio sponge, filled with pistachio paste, and coated with an orange blossom Swiss meringue buttercream and crushed pistachios.
Did I use enough pistachio? š¤š
@DrInsurgent
Ah the old āIām off to go pursue my dreams of becoming a life coach!ā
Nothing to do with recently being outed as part of a group committing academic fraud or anything.
This issue is ongoing, the 8am candidates have now left the exam 3 times because of technical issues. This is the last day to sit the exam.
@NHSE_WTE
@PearsonVUE
please can you provide some guidance; this is playing with peopleās lives.
This is unacceptable
@PearsonVUE
The doctors who have prepared hard for this exam need you to confirm immediately that there will be another sitting this week - they canāt lose a year of their career progression because of your failure.