Medical Apprenticeships. Explain it to me like I’m 5.

[W0tnow]

…because I don’t understand. According to this article, these apprentices will achieve a medical degree after 5 years of on the job training and academic study.

But the traditional route involves 5-6 years of study, (including supervised patient contact, but mostly study) and is, by all accounts, incredibly intense. How can you attend medical school, work in a hospital as an apprentice doctor, from day 1, and achieve the same qualifications in the same amount of time? How is that possible? Who is going to be supervising/ training these apprentices? The same staff who currently train first year doctors?

If I understand this correctly, (and I’m sure I don’t) the only difference between the two qualifications, is that one comes with a massive debt.

https://educationhub.blog.gov.uk/2023/06/30/nhs-doctor-apprenticeships-everything-you-need-to-know/

The government is trying to develop a cohort of substandard undertrained inadequate doctors. This is so that their training won't be recognised abroad, so they can't emigrate. And fuck the fact that it will put patients at risk. This makes me angry.

Which university was this?

They may have had pre-recorded lectures due to COVID.

Unfortunately 2021-22 was not "post-COVID" for NHS doctors. The effects of the pandemic are still hitting the health service hard and were still acute then. A lot of lecturers are also clinical, so maybe pre-recorded lectures were the only way.

If the apprenticeship is full time work, they wouldn't be able to fit in all the self study/pre-recorded lectures around it, even if they were not face to face.

@Spacecowboys where were they studying ? My DD had between 20-35 hours on lectures/seminars/practicals each week for years 1-3. Then mostly on wards or in teaching and got 6 weeks holiday. Don't know anywhere that could done hours a week - dissection was 4 alone.

Yep, I think this was a covid issue - lecturers are mostly NHS staff, so weren’t available as many were redeployed, students weren’t allowed on placement, the university closed the campus down - studies were massively disrupted.

The online stuff at our medical school was the normal programme of lectures/small group teaching etc, just delivered over Teams, so still high quality and worth attending, but I have no idea how other universities delivered their teaching and that may not have been universal.

@nocoolnamesleft bet they won't be working in the private sector. Looking after young Sunaks or Rees-Moggies.

By post covid I mean there wasn’t the restrictions in terms of lectures being able to take place. Course started in sept 2021 and this was a university in the north of England. Has this changed now , how many hours a week ‘face to face’ are medical students currently getting at university ?

I'm an allied health professional and we have an apprenticeship route which an applicant has to apply for and as far as I know they are already working in the NHS in similar roles i.e it's a route for assistants and technical instructors to develop into clinicians. So if they were offering apprenticeships to people qho already had a lot of skills like advanced nurse practionners etc then I can see how it could work. Our apprentices have been our best students by far. If on the otherhand you can have an inexperienced 18 year old doing an apprenticeship that would be very very worrying.

@Spacecowboys where DD is they are doing something in person approx 20-35 hours a week for pre clinical years.

Nursing experience is not a substitute for a medical degree. The overlap between the nursing and the medical curriculum is minimal.

It is quite dangerous to suggest that a nurse could become a doctor without completing a full medical degree.

Surely they'll have to have a science degree or something, a few exams before they start? To show they know the science? Otherwise this sounds like a terrible idea.
i'm not 100% sure but I think it is for 18+ students with A levels.
It worries me. Also I think shortening the course from 5 years to 4 is worrying. What are they going to miss out?

I think a lot of staff already working in the NHS could make amazing doctors, presuming the education and support they get is good. Ive no idea how the course content will differ. Maybe apprenticeships mean someone could specialise in one area more quickly. I..e if an advanced oncology nurse wanted to become an oncologist would their training focus more in those relevant areas? Ive no idea how it would work in practice but I do know the 3 AHPs that came through to my profession in the apprenticeship route are excellent.

So an apprenticeship route of 20 hours face to face 20 hours clinical could potentially be comparable? I assume that the apprenticeship route would be using the same universities as the traditional route do. Would be interesting to know the university staffs thoughts.

You cannot be a good specialty consultant without a proper general grounding in medicine. This kind of opinion is part of the problem. It sounds good on paper but doctors know it would be very short-sighted and train inferior professionals.

Patients don't fit into neat boxes with "just cancer"; they're increasingly older with complex multi-morbidity.

I don’t think it’s just aimed at qualified HCPs though? Isn’t it aimed at the 18 year old school leaver who would traditionally have gone to medical school?

@Spacecowboys that's 20-35 hours of just face to face, they then have to study on top of that. And they are also on wards from first few weeks. Then years 3.5 - 5 they are on the wards for 30 odd hours, having teaching for 10+ and studying on top. It's pretty intense.
I have no idea how the amount of theory they have to learn is possible if working on wards full time.
Plus who is expected to teach them ? Because there are not enough doctors to teach the current medical students, who turn up having been in skills labs and having some serious theory behind them.

I dont know anything about it to be honest. Just giving my experience of working with health care apprenticeships

Graduate entry medicine has been around for years. It's an intensive 4 year course. I imagine this apprenticeship route will be similar with theory and clinical elemente happening all year round rather than just during university terms.

I don’t think they will be working on the wards full time though ? I suspect that it will be a combination of both academic study and clinical experience- probably not in the traditional sense of 30 hours working , 7.5 hours academic. I think it will be more equally divided to ensure that the academic side can be met. I may be wrong of course and presumably the purpose of the pilot is to address exactly this kind of thing , to find the right balance.
I am going to reserve judgement for now.

@BadNomad but the graduates have science degrees, usually biomedical or similar. So lots of theory done.
And ask any GEM and they'll tell you how intense that first 18 months is.

Not necessarily. Many do not require a science-based or AHP degree. You just have to have any degree and get a high enough score in the GAMSAT/UCAT.

How would you limit that though?

So you qualify as an oncology-only junior doctor. Then, in order to become an oncology consultant, you need to do foundation training (two years rotating through internal medicine, general surgery, GP, and two other specialities), internal medicine training (three years rotating through seven different internal medical specialties and ICU), and oncology registrar training (four years, which includes dual accreditation in internal medicine).

But your mini-degree limits you to only working in oncology. You aren’t allowed to work in general surgery, cardiology, ICU etc because your medical degree doesn’t allow you to. So what do you do? You can’t even get a full medical licence without completing foundation training. You are unemployable.

@Spacecowboys but who is teaching them ? Uni staff are already stretched thin. And if they are going to be studying half the time then it's pretty much the same as a medicine degree. So why don't they have to pay the same and everyone else ?
And not sure who is going to supervise them on the wards. F1/2 s are already fed up being told to sign off for PAs (yes they shouldn't but they do because they are ordered too - however worm is turning I hear and lots now referring to the supervising consultant as not willing to be liable anymore).
If it's for nurses and other qualified ACP then it could be a good idea. But for 18 year olds with no experience sounds awful.

Being on the receiving end of the NHS......being an older, skint person, this worries the shit out of me from a practical perspective.

On another, does this mean that all the "proper" doctors will all go to more expensive private practice and we'll have a truly two tier medical service.

@BadNomad only one Uni doesn't require a science degree for GEM and those graduates have said it's a v v hard slog to catch up on their knowledge.
GEM is tough.

No. There are a many.