From GP practice managers

[Bagamoyo1]

m.youtube.com/watch?fbclid=IwAR2ZqCHbGq9Tn0WtOYD5B8y8CnjF-MjkmH2tAEz42wEArKz-pl0QRb5s9hI&v=3ru4QhVZ2a8&feature=youtu.be

@Miljea

At the end of the day, despite many of us complaining about very poor GP services they encountered during Covid- as a nation, we're absolutely okay with it.

If we weren't we wouldn't be further increasing the incumbent government's majority.

There's no point wasting time and blood-pressure over this; nothing will change while we have an increasingly right-wing government.

No we're not "OK with it", but we don't trust Labour to improve it. Brown/Blair made a lot of mistakes re the NHS over their 13 years in power and lots of people saw no improvement in healthcare despite the spending being trebled.

@ashmts
I am not a lay person - I am a nurse
Yes some people live chaotic lifestyles but if they have been on a pill for years and know when they are going to run out, they can make arrangements to renew? Or if they have unprotected sex they can get a morning after pill from a pharmacy?
It isn’t just your GP you can get contraception from - as NHS choices states
I just don’t understand this logic
“If I get pregnant it is your fault”
It’s like they have Teflon coated shoulders

Expecting the public to treat GP receptionists and other front facing staff with courtesy and respect is perfectly reasonable. As I and many others have said poor treatment is not acceptable.

I still take exception to a shitty, antagonistic video that won’t change anyone’s behaviour and am appalled that people who say they are health professionals are defending it.

[quote Thisgirlcanrun]@ashmts
I am not a lay person - I am a nurse
Yes some people live chaotic lifestyles but if they have been on a pill for years and know when they are going to run out, they can make arrangements to renew? Or if they have unprotected sex they can get a morning after pill from a pharmacy?
It isn’t just your GP you can get contraception from - as NHS choices states
I just don’t understand this logic
“If I get pregnant it is your fault”
It’s like they have Teflon coated shoulders[/quote]
Did you actually read my previous post? People (including me) did try to make arrangements to renew and were refused repeat scripts and refused appointments. There was a pandemic so all the walk-in clinics and pharmacist-led clinics were cancelled. Advising the MAP in lieu of long-term hormonal contraception is ridiculously irresponsible. I'd be shocked if you really are a nurse. If so, some CPD may be in order.

But how is it the receptionists fault??

@JMJTHEWEEDONKEY thank you. It saddens, dismays and angers me how many others have had similar experiences. On other threads inc one I started myself a few years back on medical misogyny plus what I hear in real life the incidents I hear of are shocking as I said up to and including the outcome for the patient being fatal. Completely unacceptable

I'm so sorry for what you've been through too. I've heard several times from surgeons and other specialists how too often they are seeing patients far later than they should have and the result is patients lives being severely impacted long term

Also in my experience it is not a rare occurrence nor specific to a certain part of the Uk. I've lived all over the Uk with the exception of Northern Ireland and have friends and family who also live/have lived all the through the Uk inc NI and I've heard of and experienced appalling service via gps and gp surgeries since the early 90's.

There are some good ones but to be honest ime and that of friends and family they seem to actually be in the minority, which results in their being the most popular surgery/gp and therefore it's hard to get an appointment with them because lots of people locally also want to use them.

If the majority of gps and gp surgeries operated more sensibly, more compassionately and more appropriately then many of the problems people experience would be greatly lessened

Then the nice ones quickly moved on constantly and the nasty ones were left behind

So true

Also mention of mh - try getting taken seriously about ANYTHING medical if you have a mh dx. I have ocd as main issue. But due to being mentally ill I've had physical ailments - even those with clearly visible symptoms like rashes - completely dismissed as being "in my head" so so many times

which is not what this thread is about

Actually that's EXACTLY what this thread is about, because the patients that have reacted with frustration, panic and even anger have more often than not done so because they have/are experiencing a medical issue that is being uncared for. That's EXACTLY why people are fed up with gps!

Sometimes patients become "that patient" BECAUSE it's the only way to GET the care we are supposed to!

I have a medication that I cannot (because it would be physically dangerous) even be late taking let alone miss a dose, I have learned the hard way I need a 2 week buffer (it's a 28 day amount that's prescribed each time - don't even get me started on that crap!) just to ensure I get it on time. This really should not be necessary and as a pp stated not all patients CAN be this organised and consistent with ordering meds. Supposedly it's a 48 hour working day turnaround at the surgery plus same at pharmacy but as I say I've learned I need to order early and keep chasing it

Perhaps that is the problem and they should be nationalised.

Exactly what I said upthread and should have happened decades ago

When I have experience good gps and good go surgeries any issues I've had have been dealt with AND RESOLVED far more quickly and appropriately which is surely better and cheaper for the nhs as a whole?

@pitterpatterrain As a former hcp I dread to think what will be the fallout of the lack of access to primary care for so many. I know cancer specialists are already predicting a surge in patients with advanced cancers that may be untreatable, I'm starting to hear similar from other areas of specialism, one former colleague works in cardiac care and she is concerned that there may be many patients who would normally have presented to their gps with warning symptoms that may well have heart attacks in the coming months/year that could have been avoided. As I said in my first post it really is unconscionable that gps have not really continued to do their jobs in too many cases and/or not done them appropriately/effectively

Gps should NOT see themselves as "gatekeepers" your job is to provide care and to refer when appropriate. I have a lot of experience of this NOT happening and I don't believe it is always because they don't believe a referral is necessary/warranted. My dd and I had severe, classic symptoms of at least 2 chronic conditions (I've cited our worst experiences) which were ignored, dismissed and minimised by multiple gps in multiple health authorities by gps but when we did eventually see specialists and described the symptoms we had reported to those gps the specialists (and nhs guidelines) were very clear we SHOULD have been referred literally years earlier.

There IS an alternative method - stop fobbing patients off ESPECIALLY women which indirectly means also children! There is widespread misogyny in the health system particularly in primary care. That CAN be addressed by improved training and education and by gps addressing their bias.

As for the teacher comment op - absurd piece of whataboutery!

1 teachers HAVE had a lot of criticism of their handling of COVID including much abusive behaviour directed at them

2 while teaching is important it's NOT life and death as medicine is!

GPs who have been refusing to see patients in their own surgeries have been lining up for extra shifts at primary care covid assessment clinics and central vaccination hubs. All with ‘extra’ pay.

Yes this is something former colleagues and other friends and relatives working in healthcare have observed and mentioned to me.

I’m shocked and dismayed but not surprised.

People do deserve compensation for their work but gps seem within healthcare to be the sector most focused on money.

@cjpark - it doesn’t have to be a gp overseeing vaccine rollout, there are other drs who could do this and who wouldn’t expect extra pay for doing so. In this country profitability as a business model in a service that attains patients via the nhs model shouldn’t be a factor. Gps imo should never have been allowed to operate as private businesses but within the nhs model, it was pure greed that drove this both historically and in the present. Gps trained by the nhs should have been made to operate fully within the nhs, not profit from it.

Receptionists are not clinical and so don't get to 'decide' if a letter from a specialist is important or not.

It’s not what is supposed to happen - but it does!

This is true in most high paid professions IME.

Yep! And they also can be dealing with “difficult” “clients” I have one friend who is a criminal lawyer and deals with all sorts of nonsense but accepts it is part of the job and is why she gets a good salary and compensation package.

It isn’t just your GP you can get contraception from - as NHS choices states

Actually the cuts mean that for many patients there isn’t access to sexual health clinics etc add in the fact that pharmacists can refuse to supply patients if they personally have moral/religious objections and the system is nigh on impossible to navigate in parts of the Uk. I live in an area that is mainly Catholic and several people I know have had problems accessing contraception due to hcps and pharmacists personal moral/religious objections. It’s semi rural and nearest place where this is less of an issue is a fair distance and not cheap or easy to get to. Where does that leave victims of dv, rape and csa? Certain posters are often flippant about “adults should be able to organise and manage their own contraception” not all those needing to do so are adults or otherwise not vulnerable.

In regard to this thread it’s entirely possible patients DID do as they were supposed to and contacted their gp or other primary care access to get contraception and were thwarted by poor care and poor attitudes!

I’m not currently sexually active but I have a condition that means ANY pregnancy even early stages is potentially fatal. As such when I am sexually actively I take a “belt and braces” approach in that I use the pill and condoms. Don’t even get me started on the fact that even with that medical history I STILL can’t get sterilised on the nhs! A coil is contraindicated in my case too (although that hasn’t stopped some idiot hcps trying to push that on me).

There’s so so much in primary care that needs fixing and it’s not simply a case of more money, it’s largely a case of better management and care.

Wow, so many of you 'decent folk' justifying this abuse.

"I'd never do that but some receptionists are awful...." ad Infinitum.

I've stopped reading after a short while. How can any of you justify that treatment? Any sentence that has a 'but' in hints at them deserving it. I'm genuinely shocked that you think that it's somehow justifiable.

Another side of it - not justifying the abuse aimed at GP receptionists just surprised at that video's assumption it's unique to them! There have been loads of threads just on here detailing how vile customers are to shop assistants, both during and well before covid.

I've had similar abuse at most of the customer service jobs I've had - in my first ever full time job I was told that if the caller's partner killed themselves it would be my fault - because I'd told them how much they owed the service when they rung up to ask, and that had upset them! Even in my 'naice' professional jobs - first week as a curator in a museum I was told by a member of the public to "shove my [artifact] up my arse" because I'd explained it was unavailable due to being sent for conservation!

People are just fucking awful, unfortunately, and I haven't heard anything from that video that suggests GP receptionists have it worse than others - if fact at least a lot of the abuse they get (particularly this year) has been over the phone rather than someone twice the size of you spitting in your face, as retail staff have to deal with.

I don't have enough GP's and have been unsuccessful in recruiting because who the hell would want to be on the receiving end of such vitriol and hatred every single fucking day.

Do you think it's really the vitriol and hatred though?

Or more like not enough people wanting, or actually being able to commit to a 5 year degree, a 2 year foundation course and then a 3 year specialist course? All to work 50 hours a week for £58k a year?

I'm not an expert, just someone who considered it in high school and noped the fuck out when I saw that. How many "bright" but working class / normal people from normal backgrounds can commit to that? And what would those same "bright" people get paid if they went into finance or started their own business?

Maybe it's the system that has to change. What about specific "Mental Health GPs" with half of the training? "Dermatology GPs" with half the training? I know some of the medications etc need more general knowledge but does literally everything have to go through one single person that needs to train on everything for ten years only to (in my personal experience) miss something pretty obvious that almost killed me, google something else right in front of me, and diagnose a rash V easily based off one photo in covid times?

I'm really trying not to hate and understand it must be an incredibly difficult job. It just seems the system is very broken.

And than in no way says any type of abuse is okay.

@Nicepillows

What I don’t understand is how receptionists were able to answer the phone before March 2020, and are now physically incapable of doing so.

My newborn had a repeat prescription (but I had to log her weight with GP first) and the surgery failed to send it over to the pharmacy three times despite saying that they’d done it. In the end I had to be one of those annoying patients who go to the surgery and knock on the door for 30mins being annoying until they’d talk to me. They checked the system and apparently the notes had been made but nothing done. They assured me it would be at pharmacy by the end of the day. I called in at pharmacy twice a day and for 3 days and nothing. Got through to surgery for the 4th time and the receptionist straight out told me she’d forgotten to do it.

It took over a week to get her script and approx 5 hours of me phoning.

Further, when I was getting her weighed the GP surgery said they weren’t doing baby weighing clinics and I had to go through health visitors. HV could only give me a weighing appt 3 weeks away. When I went they got pissy at me for not having it done at the GP surgery. I now know to start the process of getting my baby’s next prescription 4 weeks in advance. From reading this thread, I feel unfortunately that I’ve been lucky in getting a prescription for her at all.

I think part of the issue is that GPs are getting blamed for other services not providing what they should be. GPs are not commissioned (i.e paid)to weigh babies - health visitors are. Weight clinics pre covid were often in GP surgeries because the HVs rented a room, in other places they are in church halls, due to covid they have stopped doing this. Most GPs won’t own baby scales as the nhs pays health visitors to weigh babies. HV dosent provide a service but it’s the GP that gets the blame....

@saraclara

Of course it was down to GPs and receptionists. Who do you think is administering the vaccines? Boris and his cronies

Not where I live. My surgery isn't administering any covid vaccines as far as I'm aware. It's basically dead. Doors locked, and the very lucky people who get face to face attention...well I've never seen more than two people waiting outside to be called in.

For covid vaccinations, we have a choice of three hubs within six miles, each run by local pharmacies. Those with specific medical needs get theirs at the hospital hub, which only vaccinates staff, and those referred to it by their GP.

I work in a covid vaccine hub one day a week and as a hospital Dr the rest of the days. The vaccine roll out in the UK has been run by GPs - that’s why it’s not an utter failure like track abs trace was. Big hubs are much easier due to vaccine storage requirements but all GP surgeries have to provide staff to hubs on a Rota (as well as people like me who do it in my spare time) so that’s why there are less of the them in the surgery

@ncgy

Many people want the "normal" service and have on the whole an accurate notion of what a GP Practice can provide.

I still found it completely unacceptable why my elderly relative who had spent 6 wks in hospital & had had strokes & open heart surgery couldn't even talk to a GP to discuss post op care & get a prescription. Not every older person has someone to advocate for them. I was never rude or abusive I simply wanted to know how I could get medication for said relative.

I'm confused by practice that doesn't provide the above.

I’m really sorry for what your relative went through. However the nhs does not commission/pay GPs to do post op care - hospitals are paid a large sum of money to provide care and prescriptions for 28 days after the operation. Your relative was let down by the hospital not the GP

@ncgy

My GP has been great during the pandemic & receptionists are always helpful & discreet.

I experienced the other side recently when a relative nearly died & underwent life saving heart surgery. Care in hospital was fantastic. Discharged under the care of their GPs & it's been appalling. I've had to take them back to the hospital twice to get medication (including blood thinners which yes lack off could kill them) as their GP does not answer the phone or emails & when I queued in person to get an appointment they then rescheduled it twice, after medication had run out. I've lodged a complaint, it's unacceptable.

I’m Sorry your relative had a horrid time. Blood thinners until the patient is on a stable dose are the responsibility of the anti coagulation clinic not the GP -possibly the hospital screwed up here not the GP

baaaal raises an important point above. Why are we having to use the same service for so many different things? It's mad when you think about it. At the very least mental health, gynaecology stuff, vulnerable elderly and paediatrics could be different types of GP. Then they'd have more expertise and maybe it'd be quicker. The jobs would also be more enjoyable? When my DD was diagnosed with ADHD I had to tell the GP what local services there were.I could hear her scribbling them down! Yet these people are gatekeepers to the medication she needs.

My GP is great by the way. But I researched them (asking NHS friends) because the old one was so terrible. I do think as businesses, if they wanted to change, they probably could, but they're too small, aren't they, and there seems to be no incentive or system for the bad ones to learn from the good ones. Because actually the govt is their customer and not us lot.

@Cbtb the fact is that GPS and CCGs commission other services such as hv's/camhs, etc., and when the services they commission for their patients are not properly operating there needs to be far greater accountability and less buck passing.

I agree that the CCGs have a lot to answer for. Your average GP however isn’t involved at that high level and thinks there all a bit out of touch. GPs told the government that CCGs were a stupid idea - and they are. GPs moved away from actually seeing people into managing the health service, we need more front line drs and nurses not more managers!

There are good gp practices and bad ones. At some you could be waiting ages for a call back and patients are referred to the pharmacy inappropriately by reception only to be referred back to the gp because they need to see or speak to a nurse or doctor. Sometimes it does feel that if you are polite and placid nothing gets done and you do have to persist to get taken seriously.

Our new surgery were taking on patients in the pandemic. I thought there might be issues with transfer of data but it all went smoothly. I rang up for a repeat rx for dd expecting to need to speak to a hcp as it was the first time she would be getting it from the new surgery but they issued it. They have since contacted me for a review and we had a video consultation for dd. Dh rang up on a Monday morning and had a consultation in the afternoon for his fungal toe, a rx for antifungal tablets was issued sent to his preferred chemist and then ready to collect the next day. There are Gp practices out there who are doing a great job unfortunately these are few and far between.

I work closely with Gp practices and receptionists do get a lot of flak and abuse. it is by no means an easy job. I wish they would just be more transparent with people, for instance if you have a reduced service because some of your GPS are isolating say so. It is the GMC that have issued directions saying that patients are to be seen using alternative methods like phone consultation and video consultations where possible at first instance. That is not up to individual Gps!

Ok. So what is clear from this thread is that people equate GP with a face to face appointment and if they are not sitting in front of a patient then we must be closed, hiding or lazy.
An appointment or patient contact can be face to face, it can be by phone or by video. The fact we are seeing much fewer patients face to face does not mean we aren't providing and holding appointments with patients.
I can only speak for my surgery but we are currently offering 40% more appointments (of all kinds) than we did at the beginning of March 2020. 40% more and we are still being overwhelmed with patient demand.

I'd also like to say that it's not the genuine patient demand that is the issue, it's the nonsense as mentioned up thread.

So what is clear from this thread is that people equate GP with a face to face appointment and if they are not sitting in front of a patient then we must be closed, hiding or lazy.

That maybe the conclusion some people have reached but I think people are more frustrated by how difficult it is to access an appointment and that telephone appointments are not always useful or appropriate. My GP tried to assess my response to a Finklestein test (his instruction was actually for an Eichoff's test but I'm not sure he'd have taken kindly to me pointing that out) over the phone! He then misdiagnosed arthritis and three months later my de quervain's is chronic and I'm struggling to wipe my arse. I'm girding loins to try again and expect to be told I won't be seen.

I'm very much in favour of using technology for greater efficiency but I wonder if an audit would show repeat requests for appointments face to face because a telephone appointment hasn't resolved their issue. The efficiency benefits are all for the GP's with greater inconvenience for the patient.

Many surgeries are offering 5 hour windows for telephone appointments; a PP has made the point that we are usually given an appointment time for f2f, why is this not possible for telephone appointments, it feels as if it's intended to deter people from trying to speak to a GP. I think a PP mentioned that if they missed the telephone call for their appointment the surgery would record it as a missed appointment, which given the 5 hour window seems quite unreasonable.

So what is clear from this thread is that people equate GP with a face to face appointment and if they are not sitting in front of a patient then we must be closed, hiding or lazy.

Absolutely not at all! I am actually really glad that GPs are moving towards telephone/ video appointments and as I mentioned in my post, diagnosing a skin condition via a photograph. I can't remember if I sent them it via iMessage or email but either way, I didn't have to take any time off work, didn't have to sit in a waiting room with a bunch of "sick people" in a surgery already running 45mins late by 11am, and I assume the GP was at home with a better work/ life balance and no commute.

It was actually getting the app that was hellish. Calling at exactly 8am to a perpetually engaged number, why can't we be allowed to email? Or fill in a quick online form with relevant questions? Then "the doctor will call you back between 11am - 4pm, please make sure the line is clear" for five hours? Some people aren't allowed to have mobiles on them so calls need to be directed via a work number... what work number is clear for 5 hours?

I actually hope we see more telephone / video / email or online consultations post-covid. Especially for very routine or relatively simple things. But I hope we actually create the systems behind it to make it work.

The entire system right now seems set up to "put you off" going. I was just discussing this the other day over coffee with my mum, auntie, and gran, and we were all saying how we have a list of things we would like to be seen / should probably be discussed with a doctor... but it's such a hassle and since they won't see you for multiple small issues in one appointment, you feel like a complete time waster trying to convince the receptionist you really need an appointment for back pain / rosacea / trouble sleeping / suspected anaemia / a funny looking mole / a pain in your knee / dizzy spells / tremors in your hands / acne etc. And then there's the associated time off work because while it's a ten minute f2f appointment, you're never seen straight away. I am always at least an hour.

I feel like we are a relatively "unhealthy population" and this is one of the contributing factors. I work with US folks and the other week a workmate was saying he had been for his yearly check-up with his family doctor... I almost fell off my chair 🙃. Can anyone in the UK imagine? (I also can't imagine what they pay in insurance in all fairness 🤣 but I would absolutely pay the cost of a yearly check up).

I think keeping telephone / video / online appointments could really help with this, if as I said, the correct systems are set up to handle them.

‘Or more like not enough people wanting, or actually being able to commit to a 5 year degree, a 2 year foundation course and then a 3 year specialist course? All to work 50 hours a week for £58k a year?’

Or £88k a year

I am a Dr, though not a GP. One of my best friends is a GP though. The issue with gp care is a complicated one, in my opinion. It’s often tempting, including from a secondary care perspective, to blame lazy GP’s. But to do so is simplistic and inaccurate. And if we never seek to properly understand the problem, we won’t get any resolution.

There are many practices who provide an excellent level of care. My own GP practice is excellent. They have been seeing patients face to face and home visits throughout the pandemic. They also run the GP unit in the local community hospital, including some palliative beds. I know, because I discharge patients to them, just how good a job they do. Yet, I’ve heard some moaning locally because the waiting time for an appointment has gone from 1-2 days pre-covid to 2-3 days for a routine appointment now (though patients who feel they need to be seen urgently are dealt with via on-call GP). That is because they are trying to do vaccines, catch up with some monitoring/smears/minor surgeries (which they told to stop at the start of the pandemic, told to restart then stop again). They also have a higher in-patient rates than usual and more home visit requests.

However, I’m also more than aware that there are some practices who provide a poor standard of care. Some of those do so due to incompetence and/or laziness. Those practices can, and should be, identified and plans put in place to rectify that.

But, in many instances, the issue is not that Gp’s are sitting twiddling their thumbs having a merry old time. In many cases they are working flat out because they are working short-staffed and there are not enough of them to manage the work load. This means waiting times are far longer than they should be, GP’s are rushed, things get missed.

There are not enough GP’s- training is under-recruiting and many GP’s are retiring early, leaving to work abroad and so on. Some practices cannot recruit, despite offering quite significant “golden hellos”. In a growing number of instances, this has led to the partners handing the contract back to the health board to run. Where this has been happening locally, it is generally a disaster because it ends up being staffed with a series of locum’s (who can be highly competent, but only work one or two days then not again for a few weeks, or never again).

Our local GP practice has been using phone triaging by GPS for a number of years now alongside online booking. You can arrange a phone call with a GP of your choice ( unless it is urgent then you have to go with whoever is available). They phone you at around the time you have requested and if they need to see you book your appointment. No contact required with the dragons behind the desk.
Throughout the pandemic it has been business as usual since there was no need to scramble frantically to set up a new system and patients are already familiar with the system.
You can still make appointments via the receptionist but if you don’t fancy trying to explain why you need an appointment then the smartphone app is definitely an improvement.
Having finally lost the weight I had been trying to lose last year I became aware of an abdominal swelling. I spoke to my GP on a Thurs am. Was booked in the following morning for exam and blood test, she referred me for a scan ( all done via digital referral system) the hospital check ntacted me the following Monday and gave me a choice of appointments for the same week. By Friday I had had the scan and GP had rung me with the results. All under the NHS. And no involvement of a receptionist.

@RealhousewifeofStoke I'm not sneering at the salary, that wasn't the main point of my post. But yes the page I looked at (which I assume was the same one I would have looked at when I was curious in high school) states £58k (starting) to £88k (experienced). Though it doesn't say how many years experience you need to get there.

The main point is that it's 10 years of training to get there (plus an additional 2 at high school in many cases, 12 years). I remember seeing it and wondering how I would ever make it work? And education is free in Scotland so that wasn't even a barrier to me.

Benefits (for parents) stop at 16 or 18 if you stay in school, so it would have been a case of moving out and finding a job to cover rent or begging to stay at home and finding a job to cover bills. Two, three, four years... maybe could have swung that, if I worked and studied every hour under the sun. Twelve years? I didn't even consider it a possibility so looked no further, got an apprenticeship, and promptly handed over half my wages for digs (which is completely normal to me, I've never seen or heard of the type of parental £ support for grown adults I read about all the time on MN).

I'd only just be qualifying this year instead I had a career in engineering (yes the wages were low to start while I was training but increased massively in a short period of time and with job moves and additional specialty training), bought a home (twice now), started a business, had two children (one of whom is 10 now), got married (and subsequently divorced ).

Essentially I am a lot further on in life so in hindsight yes, I'm personally glad I didn't, but how many other people see the barriers to entry and don't even consider it? Surely General Practice (and basically all careers in medicine) need to become more accessible to the masses or we will always have a shortage of doctors and nurses.

The "vitriol / hatred" was given as the reason for a recruitment crisis, but I believe it's about accessibility. Teachers also had / have a recruitment crisis (and a lot of vitriol and hatred directed their way) and it seems like they are doing a lot more to encourage people in and make it as accessible as possible.

You can at £88k til the cows come home, but if that was enough, we wouldn't have a shortage. People would be doing it.

@baaaaal It's not ten years unpaid though... A doctor earns 30k straight out of (5 years of) uni (more if they do unsocial hours, which they will on most rotations) and that increases quickly. It's not any less accessible than other graduate professions.