To ask why we can't train more doctors?

[Turmerictolly]

The NHS is desperately short of GP's and other doctors and the system is at breaking point. I look on the regular threads on here about not being able to physically see a GP any longer and my own experience of having cancelled hospital appts which are leading to worsening health. I then look at the Medicine threads where there seem to be so many bright and promising young people willing to train but not enough spaces on the courses.

It seems like some sort of dystopian catch 22. How on earth is this going to be fixed?

More people than ever are entering GP training but it's not translating to more GPs. Working conditions and pay are not attractive, some choose to end their studies early, some move abroad once qualified.

This.

Other countries tie doctors to work in their health service for x years after investing in their training. In the UK lots train and then move abroad for better pay and conditions. We need to improve pay and conditions and force those who have been trained in the UK to stay whilst they pay back some of this investment. We also have a huge issue with UK doctors taking early retirement because of the pension mess.

There is a HUGE retention crisis in the NHS. In all areas. In all disciplines. In our ambulance trust there’s been 60 resignations in the last two months from just one area node.

Senior managers, chief executives and DOH seniors need to realise that some serious work and investment is needed to keep the staff they’ve got. And it’s not just about pay either. It’s conditions, environment, culture, lack of ongoing development, education and training opportunities, lack of appreciation, completely ineffective leadership……..Treat your staff poorly and they will leave. It’s that simple.

Start treating young doctors decently and they will want to stay. As it is, they are voting with their feet and leaving in droves. Rightly so.

Force people to work? Are you honestly suggesting this for a democratic country?

In any case, would you really want to be treated by a demotivated doctor who is being forced to do his job?

It's the same with midwifery- lots and lots of keen applicants but you need the mentors on the wards and placements where they can get the relevant experience needed to earn their pin. Even with such a competitive process lots of people drop out or leave the profession in the first year- this would be even worse if there was an abundance of places imo.

I think there should be fast track options for some specialities. Eg I would love to train as a psychiatrist but am too old to commit 11 years to it.

I have a psychology degree, an MSc in neuroscience. I don't feel like it should take 11 years to train someone like me, more like 3 or 4.

I also feel that should be a specific straining trajectory for GPs so you're training specifically for that role and you know that's what you're applying to up front.

We should also be locking people in to X number of years service to the NHS to pay back the investment we've made in them. If they want to work abroad, either they or that hospital has to pay the cost of training back.

Meh it's the same as the armed forces, after phase 2 training you have a return of service before you can leave.

I think in this case though it shouldn't be that people can't leave, but perhaps a financial incentive for those who stay ie fees written off or something. Wales does this. If you train in certain HCP degrees you have to work there for x years otherwise you have to pay fees.

Few working class people can afford to train as a doctor. Or a nurse, or as a midwife. Make it easier to train. Make those that train here - stay here for a set amount of time.

Too many young med grads burn out! They need support. Most big companies spend £ on wellbeing. The nhs - not so much…

Reduce the pension savings requirement - this has got to be the simplest tool? Then get the newly retired to train the trainees.

We need to appreciate this wonderful free at the point of access service that we have - and bloody nurture it.

Maybe some of those hospitals Boris promised to build could be teaching hospitals? Oh, wait….

If we voted for a party that wanted to look after the NHS instead of stripping it - then maybe it would stand a chance!

In 2008, BMA voted to put a cap on the amount of doctors that could be trained as more places 'would devalue' the role.

"Delegates at the annual BMA conference voted by a narrow majority to restrict the number of places at medical schools to avoid “overproduction of doctors with limited career opportunities.” They also agreed on a complete ban on opening new medical schools.9 Jul 2008"
www.bmj.com/content/337/bmj.a748

I believe that is biting us on the bum

@HistoricMoment I might prefer to be treated by a ‘demotivated’ doctor as you put it - than one who hasn’t slept… or one who can’t actually access the correct records because the IT systems don’t work, etc…

And if the Doctor isn’t motivated - then maybe the selection process isn’t sufficiently thorough? There are far too many Drs who are completely arrogant; who don’t listen, who won’t admit they don’t know, who dismiss awful health issue as anxiety. (I’m thinking here of a recent thread). Clearly we also have some brilliant doctors, but the ‘attitude to patients’ module isn’t necessarily well taught or assessed. Clearly something is going wrong…

Ask any big company to improve staff motivation. It is possible!

I meant a demotivated doctor who is being forced to do his job, not a doctor who is demotivated because he doesn't want to do his job but is still doing it voluntarily.
It is very concerning that some posters seem to think forced labour is ok. Just because other countries do this doesn't mean we should.

It's training infrastructure at the placements. And retention is a huge issue.

And frankly the medical education at some establishments could be better.

I think it’s just not that attractive as an option. I very much contemplated doing medicine at uni (I had the grades) but decided against it at the last minute. One of my close friends did do medicine.

Now, in our early 30s, i work in accountancy and whilst I earn a little less than her (we’re both on about £70k but she gets extra for additional shifts sometimes) our lives are incomparable. I work pretty much 9-5, get 30 days holiday and lots of ‘fun’ at work - conferences, business travel, free drinks, pub lunches. I feel respected and well looked after. My exams were done after 3 years and they were all paid for and I got generous study leave and time out to go to college.

Her on the other hand has been working shifts though out, and still can’t plan her life at all. She’s missed weddings, birthdays, holidays. She can’t commit to a single event because she might be working, but doesn’t know in advance. She’s had to move between hospitals meaning excessive commutes and has the pressure of saving lives. She has also only just finished her exams at the age of 30 all whilst working and she had to pay for all the exams herself.

long term, she will undoubtably be better off when she makes consultant, but at what cost to just living a normal life. This is all before she has kids to think about as well.

As a consultant, DH has been offered jobs abroad at 4/5 times his salary here. He could earn three times his wage here if he switched to private practice only.

His working conditions are awful, his department is constantly short staffed.

He loves his job and speciality and won't leave until he retires. But you can't blame people for doing what's right for themselves, people in other professions aren't condemned for following better pay.

NHS staff across the board are not paid what they are worth.

It's always todo with placement capacity. It's not just a theoretical programme. You need supervision in the workplace! It's the same problem with nurses.

The BMA has a lot to answer for.

we are also sending the wrong people to become doctors - I see too many medical students who have been steered towards medicine at all costs, and hate it, so retention is poor. I’d rather have slightly less brilliant academics and more commitment/understanding of what a doctor is.

interestingly, all my best colleagues did postgraduate medicine. I think that is a far better way to train medics.

Start treating young doctors decently and they will want to stay. As it is, they are voting with their feet and leaving in droves

It’s this.

Im an Australian doctor and UK doctors come here because the NHS treats them like shit. Massively overworked, often covering more wards and patients than can ever be safe and then doesn’t support them when adverse outcomes happen. It’s impossible to keep track of all of the subtly deteriorating patients in hospital when you are literally responsible for 100 plus patients and being bleeped constantly for fluids, paracetamol, new drug charts, discharge summaries, talk to families about patients you don’t know and deal with new admissions.

All hospital training jobs are challenging but the NHS is untenable.

Around a fifth of doctors leave the NHS after the first 2-3 years, many more within the first 10 years. Training more drs to sort the workforce crisis is like turning the tap on to fill the bath without noticing that the plug is out. The NHS needs to become a less hideous place to work force.

Any female Dr or nurse I know in 30s works 2 days a week.
Presume for NHS to be able to offer this flexibility they also need to have x2 or x3 staff to fill a position.
So training 100 doctors won't necessarily fill 100 roles.
Pay is sufficient to achieve part time job without limiting life style too much.

They desperately need to do something about working conditions so as to retain those who have trained. The situation depicted in "This is going to hurt" is really not an exaggeration.

This year 800 med school graduates were placed on the reserve list for foundation places. There are few medical school places, but an even greater shortage of jobs for those medics to go to.

Give them better pay and stop people from treating them like trash. Would you work in a highly skilled job saving lives when you're going to be also screamed at, threatened, abused, spat on etc and then reported on so you can't keep working while being investigated just because some jumped up twat didn't agree with their diagnosis? All for a low pay for all of that shit? No you would not.