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/

Maybe the profession will split into clinicians, who have done the apprenticeships, and academics, who have done the old-style degree. I don't think that would be helpful.

I don't know what the GMC thinks. I suspect that shortening the standard degree to four years won't happen. But the Gov will expand grad entry, which enables individuals to complete the five year course in four years, and say they've achieved their target of a four year route.

I was on a seminar recently with NHS representatives- they said they thought the apprenticeship will be a widening participation opportunity, and they felt it would be very difficult to get off the ground.

All the other healthcare apprenticeships have been so slow- I’d imagine this one would be a nightmare.

However- I wonder if the apprentices will be supervised by different professionals in the beginning?

You can't work abroad if your degree falls below a certain number of hours, if the degree is cut which appears to be the plan then it means people who train here won't be able to work abroad. Its sold as being beneficial for students but it won't be, it just traps them here. Maybe I'm weak and stupid but doing my 5 year medical degree was intense, I did do a few hours work at weekends but something will have to be removed for it to be condensed by a year, and unless these apprentices have experienced staff and opportunities on wards to supplement their university learning which won't be full time (9 to 5, 5 days a week) as ours was then not sure how it'll be equal either. Some of the documents say they'll get a medical degree 'comparable' to those who go to university which is interesting.

And as for 'exactly the same exams', the uni our apprentice radiographers attend doesn't have an undergraduate radiography course.

It'll be in their interests to pass as many of them as possible (though they have already had a 20% drop out rate).

I've just left the NHS after 40 years because of the plummeting standards of my fellow (now 100%)overseas trained team. Some really, really come nowhere near the standard of European
trained staff.

We believe the HCPC were told to turn a blind eye. In the same way, unis will be permitted to 'pass' these apprentices rather than admit this cut-price approach to filling the yawning gaps caused by13 years of NHS personnel planning failure- doesn't work.

As in I did paid work for a few hours at the weekend, the workload for the degree was high outside of uni.

OK, well, five rather than four years sounds better (I still think it's too short but I am aware that other countries do five, and also these days you have to do two years of internship/foundation when we only had to do one back in the day). I was imagining myself at 21 (which was when I finished my fourth year at med school) being allowed to practice as a doctor. A horrifying idea.

To answer your question @titchy, no, the uni aren't failing these degree apprentice radiographers.

They themselves know they're getting inadequate training.

Would the apprentices still do gross anatomy including dissection? That takes up a lot of your time, when you would not be on the wards but in the lab. Surely that can't be sacrificed? Ditto for things like chem path, statistics, pharmacology etc, for which you need many hours of study and which absolutely can't be learned purely in clinical settings, you need lectures, tutorials and lots of studying.

I linked to the standards earlier on this thread which provides all the skills behaviour and knowledge needed and how those will be examined.

Why are we allowing sub standard trained medical staff from the third world to come and work over here?

That's clearly a rhetorical question but my god it's just frightening. What the hell will the landscape look like in 10-20 years? Doesn't bear thinking about.

I bet on this- won’t be internationally recognised.
Same with filling up a lot of gaps with ANPs and PAs.

It's a good idea in theory because most doctors learn on the job after they qualify. A doctor can be an assistant whilst an apprentice and can learn faster this way. However the knowledge gained k the first couple of years in the basic medical sciences is so crucial and is a full time course. So I wonder if they are spreading it across 4?

The issue at present is not doctor training.!85: doctor retention. Nothing is being done to address this issue

Yes of course you learn a lot "on the job". But the underpinning learning is also vital. Cutting that won't go well.

The issue at present is not doctor training.!85: doctor retention

Bingo!

Well they didn't manage to retain me, for one (they did get 35 years out of me first though!). But my leaving was because of 1. Brexit and 2. The pension/tax debacle. Wasn't to do with the NHS (for whom I still do pro bono consultancy work).

However medical students currently work in hospitals and on placement don't they? So in effect is it any different?

So well put, and so spot on; ones training in the 80s/early 90s is still relevant to me today because I can put into context details of results and make sense of them.
I , too worry about the level of knowledge in terms of my 94 year old mother and ourselves as we age. Something I'd never really worried about until about 15 years ago.

I was also at med school 81-86, like another poster. I don't now directly use a lot of the theory stuff I learned in the first three years, as I went into a very specialised field in which you could argue that much of that early academic learning was "not relevant". However, it really WAS important, I would continue to contend. It was the unpinning of my deeper understanding of the human body and mind, and its interaction with society and the environment. No, I could not describe the Krebs Cycle to you now, or the appearance of Yersinia pestis, or the insertions of the extensor pollicus longus, and I don't need to, but I still believe it was vitally important that I learned all of those basic building blocks of medical knowledge back then, and developed the sense of how they related to each other. (I realise I sound like an old fart, I suppose).

So what part of the academic curriculum would be different for these apprentices, I still don't understand that. Medical knowledge is now more extensive and wide-ranging and complex than it was back in the dark ages when I was at medical school. I just don't see that you can compress the academic learning portion of the degree into ever-smaller time periods.

So what part of the academic curriculum would be different for these apprentices, I still don't understand that.

None of it!

@pompomdaisy not for the first few years. Those are spent on the academic studying under the current model. I did not get into a hospital ward until fourth year.

@titchy then what is the actual difference between the apprenticeship and existing degree? You say they are exactly the same? So why different names? I am just not getting this.

Apprentices will be employed by the NHS (it should appeal to existing staff such as nurse practitioners, physician associates), they won't pay fees (the levy pays these) so won't need loans as they'll be salaried.

The preclinical/clinical model was changed in the mid 90’s.

medical students get clinical experience from the start now.

@Usernamenotavailab well I did not know that (I am in a speciality where we do not get medical students at all, and my daughter, who has just finished medicine, is in another country where they still have that preclinical/clinical model).

So this apprentice model is not all that different from what is already happening then?