Do trainee doctors in the UK...

[madameratatouille]

... in GP surgeries do vaccinations for kids and do prescriptions for ventolin and get wax out of ears and things like that?

I am in France and our GP surgery equivalent has suddenly gotten very, very busy and I am wondering if we should move surgeries. We are in the stix and for years and years we have had the same doctor and were able to make appmts at reasonable notice and it was amazing, and I wondering if we now need to move surgeries as our one is so busy. Which would make me very sad. But can't bear the idea of being passed from pillar to post and no continuity or predictability - like in the UK!!

No, here that’s all done by nurses.

As Boggles said, the practice nurse does all that. We wouldn’t book to see a Dr for any of those things.

Those things wouldn’t be done by a trainee doctor or a GP, and ear syringing may not be offered at all in some surgeries even by the nurse.

Thank you. I think IAB a bit U in my outrage then

You have to go to the hospital for earwax removal. Vaccinations are done by nurses. Asthma would be initially diagnosed by a Dr, then you’d be on a repeat prescription for ventolin with an annual asthma check done by the nurse.

Thanks very much comefromaway

The ear wax removal was done last time in France by the GP with a water gush.

It seems quite different here in many ways. It is doctors and not nurses who do smears here.

Health care assistants do ear syringing in our practice, occasionally the practice nurse will do them but never a dr but not all practices offer this any more.

There is no way any of our drs would do a smear our practice nurses even do the coil fittings/removals.

We have nurse practitioners here who are trained to do many aspects of routine healthcare, far more trained than a trainee gp.

They say there is too much risk of infection or an eardrum bursting with water so they use a suction thingy in our area.

stucknoue so an experienced practice nurse or nurse practitioner is going to be more trained and experienced than a trainee gp - would a trainee gp be considered competent to do the ventolin prescription and the vaccination in the UK though?

I am thinking probably not the ear thing though to be fair I didn't mention that to the receptionist.

Most trainee GP's I've met wouldn't have a clue how to do an IM injection!

When you say ventolin prescription can you clarify what you mean.

Is this a consultation with a trainee GP that led to asthma being diagnosed and the patient out onto an inhaler, or is it simply signing off a repeat prescription.

I have asthma and I don’t even visit the surgery for my ventolin prescription. I phone up and then pick it up from the pharmacist.

Trainee doctors/GPs are primarily there to learn and gain experience. There’s not much learning to be had from doing injections, when that’s not actually a function of a trained GP.

Quite surprised that a pp's GP refuses to do smear tests. I had one done by a consultant gynaecologist who didn't feel demeaned by it at all.
In my surgery it's the nurse who does it, but I didn't know that GPs refused. I had assumed my GP might have agreed if I'd asked.

In many practises nurses and nurse practitioners deal with all routine tests and minor illnesses. Refusing isn’t because a GP feels it’s demeaning, it’s freeing them up to deal with patients with more serious or complicated illnesses.

Practice nurse here. Our HCA's would syringe ears if needed, practice nurses would vaccinate and do follow up asthma checks and issue repeat prescriptions. As a non-prescriber however I can't diagnose or initiate a new prescription.
GP's are very rarely up to date enough to do smears. Only one of our five GP's do, and not routinely. They never vaccinate.

GPs (and GP trainers) can certainly give IM injections but it would more usually be a nurse that did vaccinations.

The main reason some GPs don’t do smears is that as they are usually done by nurses so the doctors aren’t doing enough to be deemed competent. There will usually be one or two GPs in a practice who are asked to do the difficult or unusual ones. If there’s one person doing all of those then they will get sufficient numbers through to keep their skills up. The situation with consultant gynaecologists is different- in a colposcopy list they will do a smear on every woman, they do hundreds because everyone who comes to them is a woman with a gynaecological problem.

It’s about utilising skill mix. If you have other professionals doing the things they can do, it frees up doctors to do the things that only they can do.

It is a repeat prescription for ventolin so that is fine, no worries there, assuming the receptionist was right that trainee doctors can do prescriptions.

I am not worried about the ears as they can have a look and take a view and we can go back if necessary.

I am more worried now about the comment by a pp that most trainee docs wouldn't know how to do a IM injection though

Also, it’s worth asking what you mean by “trainee doctor”. In the UK that means a medical student ie someone who is not yet qualified as a doctor. A “GP trainee” or “doctor in training” is a qualified doctor who has finished university and is working as a doctor but is training to be a GP.

Trainee GPs can definitely give IM injections. Seriously, in the UK, by the time you’ve finished medical school and foundation training, you’ve had to have it observed and signed off formally, as well as doing it as part of your job pretty often.

Taybert I was going to say the opposite. I'm a hospital doctor and have probably given about 5 IM injections in nearly 20 years. I suppose I have the luxury of not doing house calls and almost always having a friendly nurse in the vicinity to assist.

I think they are trainee doctors - in their seventh year I think. I think that they are there as part of their training and they are seeing patients because there are not enough doctors, but I might be wrong.

In the UK they would be known as junior doctors. Qualified to treat and diagnose under supervision but it would be in a hospital environment, not yet GP.

Junior dr here. I've worked in France too so understand there are some significant differences (though trained in UK)

Some incorrect comments on this thread: all doctors can do IM injections. I did hundreds as a student, they're straightforward.

Ear syringing is not usually done at the hospital. It's area dependent but you don't need to be a nurse either; a HCA can do that, it's v straightforward.

Trainee GPs here can pretty much do everything a GP does apart from things like minor surgery which are sometimes separate qualifications. They're under supervision but are experienced and will manage most things on their own and do it well. Ventolin prescriptions are straightforward but would usually go through a practice nurse who does asthma checks.

Anymore questions fire away. It can be v confusing!

Sorry just to add yes we can do vaccinations but usually that's a nurse who would do them! At med school we did them on each other to train ourselves up