To think the BMA have misjudged with another doctor's strike? Thread 2

[Locutus2000]

Rolling this over as people still seem to have something to say but no new poll.

Original post

AIBU to think the BMA have misjudged with another doctor's strike?

Last year they got more than anyone else in the NHS along with an improved deal. Nurses and other AHPs received lower rises.

BMA have just announced another 'resident' doctor strike continuing to chase pay restoration to 2008 levels.

Having just had the major win with changes to IMG prioritisation and the clamp-down on PAs it feels a bit tone-deaf and I can't see Streeting going for it.

Whether people like it or not - A PA has a post graduate qualification for their role an FY1 does not.

I personally think that newbie PAs in their first job should be paid Band 6. However, GP land paid them Band 8a which made it impossible for hospitals to recruit PAs .( whether you agree with it or not)
An experienced PA on Band 7 -absolutely, where they are employed appropriately, they are a valuable adjunct to the healthcare team. Like any profession there are a few bad eggs and yes mistakes happen but the ones I work with our knowledgeable skilled, hardworking and valuable members of the team. They are having a pretty shitty time at the moment, careers threatened, skills denigrated and being accused of killing patients. They are humans with feelings and the medical profession would do well not to blame their woes on PAs, some of the medical professions woes are of our own professions making and we would do well to own our part in them.

Please note I have said nothing of pay progression - which PAs currently have none and doctors have lots.

So as an example I know of one PA who did a food science degree (definitely not med school calibre) and a two years PA Masters with an entry tariff of any science degree and a 100% success rate on their course. Are you really saying that this individual is worth a £47 k starting salary over an F1 who has qualified as a doctor after five or six years of med school?

There are two routes to Physician Assistant qualifications (name is changing post Leng Review once universities receive GMC guidance). Either a 2 year Master level course for previous graduates of many different disciplines, not necessarily life science-based, or 4 year undergraduate course with integrated Masters for those who haven't done a degree before.

Medicine is 4-7 years depending on institution and whether the course is Graduate Entry (GEM) or undergraduate, and whether the uni has mandatory or optional intercalation leading to additional BSc or Masters level qualification alongside MBBS. So many many many F1s will already have a previous degree (GEM plus a growing number of graduate also taking the traditional 5 year route) as well as postgraduate qualifications or other intercalated degree and a minimum of 4 years of intense, clinical science-based studies, anatomy teaching, clinical examination skills teaching and multiple placements across varied disciplines.

I mean no matter what you think about the calibre of medical students and the modern curriculum, it is laughable to try and justify a PA's higher salary on the basis they have postgraduate qualifications. They learn a fraction of what medical students do, largely protocol/clinical guideline following and some clinical examination. I am not being derogatory, this is just how it is. We have some former PAs in our medical school cohort and they tell me it is worlds apart. Yet still the naysayers will try every baseless argument to justify higher pay.

On paper (and legally) PAs are to be supervised by consultants. However, in practical terms, consultants are not on the wards. Hence F1/F2s are being expected/asked to prescribe for PAs, order imaging for them, scribe on 'their' ward rounds and take on all the clinical and legal risk attached to those tasks (i.e would be the person blamed by GMC and legally if any errors were made, not the PA who has seen the patient and asked for it). This is completely against all guidance but Trusts are expecting /requesting this regardless, so a lot of the time, the resident doctors will have to see the patient again. So it's no wonder really that the line about higher paid assistants is out there and why resident doctors might be feeling a tad angry about it!

That is not what I said.
They are not training to be doctors, they are training to be PAs and equating everything to the fact that doctors spend more time at medical school and learn more and should therefore be paid more is a weak argument.

It is quite sad that the attitude of many of my fellow doctors is that doctors should be paid more simply because they studied longer and had to take in more. An experienced ITU nurse with 5-8 yrs experience, a 3/4 yr degree and probabaly some post grad bits as well is on Band 6 pay. Do I think they should earn more than an FY1 - quite frankly yes.

I'm a mature medical student and mother, plus former NHS staff/management so not your typical idealistic and self-confident bright young thing and I do have a lot of experience in non-clinical roles and service delivery. I'm definitely NOT saying doctors should be paid more just based on longer and more intense study. In fact, I would absolutely agree re a very experienced ITU nurse. The key word here is experience coupled with a lot of on-the-job knowledge though. PAs simply do not have more experience and knowledge than an F1, regardless of their qualification being PG, which justifies higher pay (especially when considering how many medical students are previous graduates and have PG qualifications/intercalations themselves).

You still haven't addressed my post about the PA (who was far from the calibre for med school)with the food science degree and a PA masters (from a course with 100% pass rate) earning more than an F1 at 47k. Any comment on this?

The PA with a food science degree and 2 yr masters - how do you know she was not the calibre for medical school?

She did not train to be a doctor, she has a different role.

Why cant a PA with 5 yrs experience have knowledge equivalent to a junior nurse or FY1? An FY1 may have a lot of theoretical knowledge but their practical knowledge is lacking in most cases.

Can't junior doctors see with nurses now debating strike action the government simply can't agree to massive pay awards for doctors without precipitating a series of escalatory public sector strikes. This is yet another reason the doctors simply have to stand down as the 'war' with the government is one they can't win and further strikes will only being more harm to patients and more reputational damage to their profession.

The talks have to get round to non pay issues and the BMA quietly dropping their pay demands.

Healthcare delivery evolves and different professions - physiotherapists, pharmacists, audiologists, CNS, ANPs - all these developments have benefitted patients.
PAs are an evolution of this - we should look how their roles can benefit patients rather than blaming them for the woes of the medical profession

@stuffedpeppers the PA I was talking about failed 11+ to get into independent selective schools. Got an A and a couple of Bs in A levels in non-selective independent school. CBA to even do D of E Bronze never mind volunteering necessary for applying to med school. Hadn't worked a day by end of Sixth Form. So I don't think med school interviews would have gone too well. Scraped a 2:1 from a low ranking university which was the ticket to the PA masters course. So in this case low calibre, inexperienced and earning £47k as a starting salary. I don't agree with this second round of strikes but if I were an F1 working alongside someone with that kind of profile and earning less, it would hardly be motivating. Or are you telling me that the first three years of the food science degree are more relevant than the first three years of med school?

The difference is that i can understand what unique skills each of the aforementioned MAPs bring to multidisciplinary team, i have yet tonsee anyone describe a unique skill, or combination of skills that PAs add, that arent already provided by existing professions.

ShellacChopin - one of my colleagues got a BCD in his A levels from one of the worst schools in the country at the time - no teacher for Chemistry which he got a C in self taught.
His mind, intelligence and acumen are way above those grades. He is a superb doctor, teacher and mentor to many.
Your derision for other peoples skills and knowledge is quite offensive.

And no I do not think an FY1 should be paid more than everyone else in the clinical world simply because they went to medical school.

Great story but not at all the same thing. This person had every advantage including eye watering school fees, small classes and excellent teaching so the Bs were a true reflection of their ability. Please don't try to shoehorn it into context, it wasn't. There is nothing at which to take offence.

That wasn't the question I asked. As a reminder, it was whether you think a newly qualified PA with this profile should be earning more than an F1.

I just find it a tiresome red herring. What PAs are paid has no bearing on what FY Drs should be paid. Maybe PAs are overpaid. Nurses are very definitely underpaid. Neither of those has any bearing on what Drs should be paid. FY Drs are early in training and I expect to have to give a lot of supervision and training to them as a future investment rather than relying on them very much as part of the team. If it turns out after a while that I can rely on them I consider it a bonus. The pay seems to me perfectly fair for what they do with amazing opportunities to progress and earn more within a few years which other professionals do not have. Nurses are often stuck on a B5 or 6 for decades.

If Drs want to make direct comparisons with other NHS staff they can join Agenda For Change payscales which are a whole lot less advantageous than Drs pay scales.

You have the luxury of it being merely a tiresome red herring as you are not an F1. For an alleged psychiatrist, you seem to have a stunning disregard for how this PA situation might make an F1 feel.

No different to how brilliant PhD students all over the country feel in the knowledge that schoolteachers are better paid. They suck it up, ad I did, for the chance to do something they love and to progress.

Having been in very similar shoes I am not impressed by an over focus on tjis comparison.

How long are Doctors F1's for?
What's the difference in pay between an F1 and an F2?
What's the pay progression for Doctor's in comparison to Agenda for Change?

You're talking like F1s are stuck on this salary for years.

They are F1 for one year!
Then F2 for one more year
Pay progression is pretty decent thereafter.

Thank you the Pure.
Making this a battle against PAs is the wrong way to fight your cause.

Shellac - in every job people will have more qualifications than others but if there is a national starter salary than that is where they start. The PAs did not choose their starting salary so stop blaming them.

I think FY1s are paid well for the level of knowledge, experience, hrs and skill set that they bring on Day 1 of the job. They then get a £6000 increase on their basic alone when they enter FY2 and in 3 years a £13000 rise on their basic.

Contrast that to a Band 5 nurse who has to wait 2 years to get a £2300 rise on their basic, they then spend another 2 years to get a further £4000 rise on their basic.
So in 6 years a nurse increases on her starting salary by £6000 and a doctor after 6 years will have seen an increase of £25207.

And before you say it a PA would have seen a £6500 increase in their salary over 6 years.

Stop obsessing on PAs, focus on what is wrong and right with medical education and help improve it rather than insulting other skill sets. Rather than see PAs, nurses, physios etc as the enemy and inferior because they did not go to medical school, work with them as part of the multidisciplinary team for the good of the patient and you might find that collectively you can do good.

No one is obsessing. No one is saying anyone is an enemy. No need for outrage and ad hominem. It's really quite simple. You claimed in a previous post that a generic entry point PA is worth more than an F1 at that snapshot point in time because they have completed a Masters and ergo are more academically qualified than an F1 after 5-6 years of med school. I illustrated with with my food tech PA example the absurdness of your post. It's bizarre, if you are a doctor, that you don't realise where the bar is set with some of these PA courses.

Thank you to the medical professionals on here for explaining the ins and outs and giving accurate information. There's been so much hyperbole surrounding pay, coming from the BMA that has damaged public support. The tactic of what looks to be their derision of fellow colleagues is a cheap shot and has backfired.

I illustrated with with my food tech PA example the absurdness of your post

Not quite. You tried to generalize from one particular example, just as on a previous thread, someone (very much with an axe to grind) gave the example of an IMG who she couldn't understand. On the same basis, it would be entirely possible to give an example of an F1 or F2 with very middling GSCE and A level grades from a leafy comp in the South East who thinks he's everyone and yet who is the despair of the nursing staff on the grounds that he simply isn't cut out to progress, and appears to look down on them despite the fact that they are not just way more experienced but way more intelligent and way better on the social skills front. His key problem is that his mother has told him he's awesome, so he genuinely believes that he is.

No-one is proving anything here or illustrating anything of value.

Not generalising at all. I was specifically answering the question about how did I know the individual was not of medical school calibre. If you are scraping Bs at A level in an expensive private school, you are clearly not meeting the minimum 3 As or A star A A that is standard offer for medical school. It's really not that deep.

I think when you are talking about middling GCSEs and A levels, they would only be accepted in contextual cases and the individual I spoke of was the polar opposite of that in terms of their circumstances.

Sorry RL intervened last week but yes this was exactly my thinking. Even if the puzzle structure doesn’t come “instinctively” then drawing it out broken down into steps takes minutes and yes truth tables would be a useful method to include.

I suspect the lack of good graphical ways of thinking and communicating reflects more on how we teach maths and general education priorities than innate ability. Its definitely something which can be taught and learned, even to quite young children.