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

A nursing degree is also an intensive full time degree with no summer break - it doesn't mean you get to add on years - that's just muddying the waters!

@Neurodiversitydoctor delivering the placenta is a non job until they pull it out so hard your entire womb follows 🙃

This is the same as HCAs being brought in to be 'cheap' nurses. They have no training whatsoever and do things like take observations sometimes without even knowing what they are doing.

Don't get me wrong there's plenty of very experienced HCAs (who should be being paid more!) But the issue still remains. I know some hospitals don't allow HCAs to do observations anymore due to issues.

I don't disagree but if the PA was assisting/ delivering the placenta presumably the surgeon would be there too ?

FWIW I'm an obs anaesthetist and have seen enough 'exciting' electives to know they absolutely need to be treated with respect and a really good surgical skillset, including the ability to manage the unexpected at very short notice.

Well yes, that is true of any delivery really, that's why they happen in hospitals. Seriously ELCS is an incredibly safe and straightforward procedure, thats why women sometimes request them in preference to a vaginal birth. Now an EMCS is an entirely different matter.

delivering the placenta is a non-job right up until it isn't though...and then it can turn into a massive sh1tshow pretty quickly.

are you sure that was an AA?...it sounds more like an ODP/anaesthetic nurse...which is a completely different role, has a very long history and is extremely important in the provision of safe anaesthesia.

it's not rude to point out what you are saying is not based on any actual understanding of a very complex system. of course uk graduates get priority. I am someone who has been through the uk doctors training system. i have applied for training contracts from foundation to specialty training after graduating in the UK and am faced daily with the issues caused by lack of doctors and have worked with multiple PAs. you have read a couple of articles and had one bad experience with a PA and are trying to explain to me how the system I have been part of for most of my life works?!!! do you also go and speak to eskimos about how they have been building igloos wrong all these years?

I have tried to explain my point of view in a great deal of detail and you keep coming back with nonsensical responses. perhaps you should re read my answers.

clearly you have an issue with PAs, I have no beef with that.

@therealcookiemonster sorry but what doesn't make sense ? Australia gives priority when providing jobs to their own trained doctors (nothing to do with nationality, everything to do with where they trained). So UK doctors get the jobs that are left. Same in New Zealand, America, in fact every single other country except the UK. I totally agree that everyone should have the right do work and travel abroad, but why do we disadvantage our own graduates when no one had does. It's not racist (I am the child of immigrants), it's common sense. Everyone bangs on about how much it costs to train a doctor at medical school, surely we want to recoup that by letting them work in the NHS ?

No need to engage, but no need to be rude.

Something has gone very wrong wrong.

Well I don't disagree with that, last time I checked there were plenty of ELCS lists to go round.

yes but that is not what that poster was describing. I have supervised actual anaesthetic associates and they can play a useful role with limits.

the nhs jobs website is a good source. i am not an employment agency! if you do indeed know f2s desperate for a job, they will know where to look.

your previous post re uk "not prioritising uk graduates" etc is very confusing and I don't know what point you are trying to make. I won't be responding to any of your comments because frankly you are not making any sense and I have better things to do. ciao.

@therealcookiemonster sorry, me again. Can you send me the trusts with jobs going as I know several F2s desperate at the moment. Thank you.

@therealcookiemonster but there are Anaesthetic Associates, who have been working independently. But it's ok, a doctor is nearby 'supervising'. All fine, until it isn't,

@therealcookiemonster Do you know that we are the only country in the world who do not prioritise our own doctors ? So increase in IMGs and 500+ applications for a trust job. They close within 4& hours as too many applicants. GPs being made redundant, F2s not even getting interviews for ANY job - not even dreaming of getting a training number. There are no jobs. There are doctors wanting to do one.

I know it's always been competitive to get into specific specialities, but since when did we train doctors to not provide them with jobs. 1,000 newly graduated doctors do not have a job in July. And won't find out where they are going to be until July. NHS had 5 years to plan this, they knew how many doctors we were training. No shortage of PA jobs though !

that's a totally different thing to PAs. all Anaesthesists have an assistant. they make no decisions or provide any actual care.

sorry to say but you are fundamentally misunderstanding the way doctors training works/job allocation works.
the issue with foundation training job allocations is to do with the new software they are using. its not that the f1/f2 doctors don't have jobs, it's that they have not been allocated them. f1/f2 jobs are guaranteed for uk graduates (unless someone does something to lose their ability to practice which is v rare at that stage). yes the new way of allocations has caused a massive shitshow but it has nothing to do with PAs.

the ones going from foundation on to specialist training are also not affected as training numbers haven't been reduced. it has always been the case that at the end of foundation training, some doctors are unsuccessful in getting into their chosen specialty. they usually find another non training job while they reconsider their options until the recruitment for specialty cycle starts again. there are sooo many unfilled Dr roles. in every Trust I have worked in there are so many empty slots and they are continually recruiting doctors from abroad to fill those roles. we used to have a good, reliable supply of docs and nurses from the EU but many left after brexit.

I also think you misunderstand my opinion on PAs, I am not happy with the government's current approach of trying to bring in huge numbers of them while ignoring the real problems. i think that as allied health professionals they can (emphasis on can) be very useful and there definitely is a place for them in the future of the NHS.

Increase in medical school places is no good unless there are places for those graduates to work
https://www.bbc.co.uk/news/health-68849847

My niece is a year for med student. Not only are PAs taking training opportunities from F1s PA students are taking training opportunities ahead of med students.

Yes a bit like saying flying a plane is easy. Until it goes wrong. You wouldn't let a plane fly with no captain!

And as someone else said....if PAs are doing surgery then how do the next junior doctors get trained.

Good point, I didn’t think of it like that.

@GreenFairies but that should have been a doctor assisting. So in a few years they are the consultant! Instead the poor doctor was probably stuck doing the admin on the ward - the job that PAs were supposed to do.

I had an anaesthetist associate during my c section. There was a main consultant anaesthetist who did all the work and he was there helping her by giving her whatever she asked for, holding things, etc.

After I saw the many posts about it on MN, I was worried when I saw him, but honestly, I can see why they’re helpful.

@Destiny123 can see a role for them, as long as not taking doctors jobs or training opportunities (so we have some consultants in 10 years). Because I think we'd all prefer ourselves and our loved ones to be treated by a doctor 🤷‍♀️

Theres definitely a lot of cases of them at least assisting (and think 1st operator for lap choles)... if you join the Facebook group the oncall room they're often highlighting this and showing freedom of information requests on PAs filling junior rota slots. Can't remember the trust now for the lap choles but was in England somewhere