To put that I don’t want to be treated by PAs in my ELCS birth plan?

As I said because a doctor could supervise more than one PA. Supervising doesn't necessarily mean standing next to them watching them.

Rules required for IMGs to qualify for speciality training.

I support students into medicine. Some go abroad for Uni so we research how they come back.

@therealcookiemonster oh and 11,000 people applied to be GPs for 4,000 posts. GPs being made redundant.

www.pulsetoday.co.uk/news/breaking-news/swathes-of-gps-at-risk-of-redundancy-as-gp-at-hand-owner-announces-consultation/

Did you do MSRA ? Seems a strange exam to me. Even students in top 20% didn't get interviews this year for some specialities.

Things have changed, massively in the last 12 months. I'm not saying it be provocative. I work with many young doctors and they are worried about their employment. Surely as a doctor that worries you too ?

@therealcookiemonster but you applied a while ago. Rules have changed. Or is the BMJ lying ?

I'm not sure why you get so cross. The rules have changed, in a lot of ways, in the last few years.

@Riversideandrelax why bother - doctor could just do it themselves. Much quicker. And safer.

And yes, PAs are v cheap to train. I think that's the problem - the training is very basic.

But they cost more than doctors for 8 years. So not really cheap to employ, when need supervising by the doctors earning less than them. Unless the consultants do it, as per BMA guidance. In which case. Not cheap as need a consultant to be there at all times to supervise.

PS most doctors will repay £250,000+ on their student loans over 30 years. So not sure they cost too much in real terms.

ffs have you read the full nhs specialty application guidelines? no? because I had to. because when I applied (and i had to apply twice because i am a dual trainee), I wasn't a UK national although a graduate from UK medical school.

After that I had to do a lot of research in the last year for a relative graduated from abroad (non EU) who wanted to train here. she wasn't eligible to apply in the first round.

the favouritism referred to here is that once they apply (I.e. in the second/third rounds of applications after all eligible UK nationals/UK graduates applicants have been given a post that they accepted), they then can't discriminate between imgs and UK grads. which is a moot point in a lot of specialties because applications don't even get to second round as there are not that many jobs. there are exceptions eg. EM and GP which are undersubscribed.

please spare me. I am no longer interested in this convo. if you want to prove yourself right so badly, take the win. I lose you win. you are the big expert on how nhs employment works. now please go away and leave me alone ffs.

Excuse me??

But the PAs cost a lot less for their training. And in terms of supervision a doctor could supervise more than one PA.

@therealcookiemonster yes they are. From 2019.

IMG Doctors
Speciality training positions can be very competitive depending on the speciality in question. There is no favouritism based on where applicants have graduated from. This means that candidates from international medical schools (IMG medical schools) and those from British schools have the same chances of gaining these training posts.

Full document

www.bmj.com/careers/article/a-guide-to-img-applications-for-specialty-training-in-the-uk

non UK nationals are not even allowed to apply for training contracts unless they graduated from UK medical schools in the first round of applications! what on earth are you talking about?

you are confusing training contracts, which junior doctors need to have to go into training jobs where they both work and train and service provision jobs which do not have any scope for formal advancement or further training. immigrant doctors can go into the latter because almost all UK medics are aiming to avail training posts and hence there is a big demand for doctors to fill the non training posts. sometimes UK medics will do a short stint in a non training job while they wait to get into their chosen specialty. UK graduates and non UK graduates very rarely compete for jobs as a result.

birth plans are more a guide. labour is complex. you may have had crap care but healthcare providers are usually focused on keeping patients safe and that can require birth plans to be thrown out of the window

@Neurodiversitydoctor what is your speciality?

A B6 is an experienced nurse! Yes they are NICs everywhere but they are hardly nursing assistants!

that's the problem with having done a few easy ones without the benefit of a lot of experience (as one might expect with a PA) - you don't know what you don't know and might be tempted to crack on without thinking 'hang on a sec, what could go wrong here'. Uterine inversion is a rare (extremely rare at c-section) but life threatening complication which needs very quick and skilled management. And if all you did was take placentas out you might not make the association between the cardiovascular presentation of an inverted uterus (because it's the cardiology PA that 'does' hearts) and the bloodbath that's about to take place. Now clearly I'm being a bit dramatic here, because hopefully a few other people might be in the room who did have the skillset to spot and manage an inversion, but you get the idea. There are some things that are only easy in retrospect and until it was easy you need to be able to manage all the possibilities...

@Neurodiversitydoctor yes, uterine inversion. Narrowly avoided a hysterectomy.

What a B6 in charge??

Is that all they have to do - a MCQ exam? No practical exams or a Viva? Do they do assignments too?

Another unlikely thing

Thank you, this whole cutting through 8 layers of tissue and removing a person from inside the other with some organs involved doesn’t at all sound like a walk in the park to be blasé about with all the potential for shit to hit the fan that such a procedure would involve.

twitter/X is really good for videos of dancing cats.

That's terrible! Our wards are often understaffed but at least always a sister in charge!

Highly unlikely a consultant obs/gyne would go “here’s the knife, I’ll watch!” To a PA 👀

For anyone interested in the plight of some of our young doctors

www.bbc.com/news/health-68849847.amp

@therealcookiemonster I really do respect your experience and it's interesting to hear your take on things. BUT for the last 2 years UK graduates no longer have priority - was deemed illegal after we left the EU. Sad, but true. This is from Reddit

https://www.reddit.com/r/doctorsUK/comments/187dqu1/justaalittlereminderritwassourownnroyal/

I had a birth plan. Went out the window after 15 hours.

Ime, birthday plans are never read by HCPs. They just ask for consent in the middle of things when you're not in any frame of mind to remember what you wrote on your plan!

Is that actually a thing ? I delivered placentas as a medical student....no one told me that could happen 😮