Resident doctors synicsl strike again

[uneffingbelievable]

The resident doctors have once again announced a 6 day strike to co incide with a bank holiday weekend.

Whilst I support fair pay and working conditions I have lost all sympathy with them. This is not poverty when you are being paid as a whole package 40-95000 gross on a 44 hr week depending on your seniority.

The arguments about lack of jobs did not stack up with more jobs going to home graduates than IMGS despite the hysteria and a huge number of home graduates not even bothering to apply.

They are coming across as tone deaf and entitled or am I missing something.

@poetryandwine I think C interview more applicants than O don’t they? I think the important stat is how many do they actually take from the background I commented on below.

As we can see, blanket policies capture exceptional schools and very intelligent families who just choose to live where they do and work out that’s advantageous. I have every suspicion doctors come from these families not the ones with multiple fathers, domestic violence and no one in the family working, plus low level attainment of their parents and grandparents. The odds are these dc are not going to be doctors in any meaningful numbers.

Are you a granny @poetryandwine?

Or are you calling @mumsneedwine a granny?

I think Cambridge do interview more. The Cambridge POLAR 4 statistics for the three years 2022-2024 Medical School admissions are

Q1 55 acceptances, 7.4% of acceptances
Q2 64 acceptances, 8.6% of acceptances

In other words, applicants from areas of the UK in the bottom 40% in terms of participation in HE represent only 16% of those who accepted offers to study Medicine at Cambridge over these three years, and those from the bottom 20% represent only 7.4% of acceptances. Almost everyone who received an offer accepted; that isn’t the problem.

55 acceptances is only 18-19 a year. Nothing to get giddy over.

Oxford admits fewer students. Q1 acceptance to medical school is only about 14% and, sadly, the higher the school is ranked the lower the Q1 acceptance rate.

No one here has captured my views exactly. I think it is good for society to see diverse faces in all professional roles, certainly including doctors. I know some horrific instances of superbly qualified minority female doctors (even consultants) subject to abuse by patients, partly I think because they are so exceptional in the current system. Economic diversity amongst patient facing doctors is important, also. It is good to stretch the conscious and unconscious biases of the middle class!

Ideally the talented who have lacked middle class enrichment opportunities would be offered free after school, holiday and summer opportunities from an early age so that they could compete on an equal footing. But this is not really feasible at scale. So I think there is a place for limited contextual offers. They work well in my School.

I want competent doctors. I think we should prioritise the British trained, but those who can’t make it - and I think a traditional early years curriculum makes this clearer, sooner - should perhaps be off ramped earlier, as PG students are, with good career pathways.

On an unrelated note, I think it is axiomatic that we should never generalise. The most intelligent fellow I know - and considering my circle, that’s saying a lot - comes from a background most MumsNetters would sneer at. My own tutees have been full of surprises, too. The Cambridge data above and much more shows that you are broadly right, but all the more reason to keep our eyes peeled for the gems.

The only person who calls me ‘dear’ is my Granny.

Your comment was inappropriate.

It was a reply in kind. @mumsneedwine hardly used the word ‘dear’ as a term of endearment, as you are very well aware.

At least her reply was witty!

I did not find your comment funny at all and your other comments on this thread show you don't really have a filter.

This thread has gone way off topic.

And we should stop pretending that doctors are in any way impoverished. They are mostly poshos to start with, they are striking because they want to earn even more money. And it's all the expense of people who earn much less than them, many of whom are themselves impoverished.

Bless you. Poshos ?? None that I know. They all went to the local comp. Many lived in council flats.

They are my students so I know them v well. You are v welcome to come and meet them - just drop be a DM.

@poetryandwine My grandfathers and father were working class, so diversity is personally attractive, and a diverse peer group is probably more fun, but by prioritising diversity a complete dog's breakfast has been made of medicine.

The educational literature is overcrowded with articles telling us that high academic attainment is a barrier for admission to the medical profession. https://doi.org/10.1186/s12909-019-1918-y before theorising why this is a bad idea and pushing DEI initiatives. Cambridge did a similar thing with their general admissions, but unlike medicine they backed off a few years ago, because they were, as you showed, having little effect in improving low SES admission rates; and their results were starting to look embarrassing - privately educated students, for example, are currently 50% more likely to achieve firsts than state educated students.

No one has bothered to look at the consequences of DEI for medicine but we know that prior attainment predicts success in postgraduate exams, GMC sanctions etc. We know at Cambridge, there were no examples of any non-academic characteristics associated with disadvantage having a positive effect on undergraduate examination performance. We know that the content of medical degrees has been reduced as the ability of the intake has declined, and the graduates from these courses overestimate their abilities. Despite this, more than 80% of medical graduates are not satisfied at the prospect of being doctors, at least in the NHS. It is therefore not possible to argue that we are selecting the right people. In the private sector things would sort themselves out, here not so much.

Pot.

@mumsneedwine But they (how many?) are not typical of the school population wanting to be doctors as a whole. They are complete outliers. You won’t find this situation in many areas. Refugees in council housing - maybe.

@Marchesman I don’t think medical schools are choosing the right candidates either. One would imagine the increased numbers are allowing applicants to get selected who would not normally? Would I trust a university of Buckingham medic being trained at MK hospital? Possibly not.

I’ve found some doctors see patients as an inconvenience. I also agree about the NHS. They cannot sort anything out. The staff go on strike.

Working class is interesting. I know umpteen people whose parents were working class. Mainly because they didn’t pass the 11 plus and had no chance as dc. They often worked locally and rose up via company training and they did get onto courses via work and saw the benefits education brings. Idiots like Starmer say they are working class, but he never was. His mum had a profession. My fil was a toolmaker too. That was considered skilled work. No qualifications because the war interfered but they bought a house and had a car. DH had a grammar school education but left any notion of being working class behind and went to university. Millions of people did this or did part time study like me. We were very poor but weren’t working class. All of us went to grammar schools. The working class is now difficult to define but so many are now middle class, the small numbers for some polar numericals doesn’t surprise me at all. There are not vast untapped extremely bright dc battling against the odds in large numbers. I do think we need the best to be recruited to robust courses.

For clarity, and I am addressing this generally, I do not think I suggested that diversity is more important than attainment. I do think society has an obligation to cultivate talent where it is often easier not to look and wants only a chance, and for a variety of reasons we make only a patchy effort.

I want doctors to be high attaining; however this increases the moral obligation to provide the opportunities to make attainment possible. My understanding is that the dearth of opportunity makes this question very difficult to sort at present.

The very high percentage of unsatisfied doctors does suggest that something has gone badly wrong. But just who are these unsatisfied doctors? Is it known, for example, that they come from PBL programmes or medical schools with lower entrance requirements? It seems logical that a strong education would help one to withstand the resident doctor years. (Certainly better prepared PG students tend to be more successful at doctoral studies, although there are confounding factors and the analogy is not perfect)

If dissatisfaction is statistically linked to the same factors that create weaker doctors, is there any chance that this will be an impetus for change?

I don’t care about those who don’t belong in medical school; but in light of the fact that only 14% of those with a place are from Q1, how many of the concessions for coping with weaker students are being driven by DEI?

Thanks very much

@poetryandwine What does dearth of opportunity look like? If medial schools bend over backwards to recruit from under represented groups, you could say they are getting opportunities. It’s whether this is producing better Doctors is surely what we as tax payers and patients want to know.

That’s too late. Students need to enter medical school - let’s go further and stipulate strong medical degree programmes - on an equal footing.

For this they need the same study skills, self confidence and A levels. Work experience is realistically not so important, at a guess - we could ask the consultants on this thread. However many YP find it motivating, enjoy discussing it, and may use it as a form if competition amongst themselves. So YP from disadvantaged backgrounds need the same access to WE, academic enrichment, etc.

The whole package that helps the MC succeed at university. @Marchesman posted a shocking statistical advantage that privately educated students have when it comes to gaining a First. If their secondary education is excellent, they will begin university with an advantage but any explicit knowledge from sixth form will only go so far. The biggest advantages will be in the realms of study skills and self confidence. YP from disadvantaged, disorganised backgrounds can barely imagine much of what they are missing.

A place to centre their education with like minded peers is invaluable.

🫩 no, many many people live in council housing, not just refugees. I really do despair. We send about 10+ students a year to med/dentistry (we are a v large local academy chain). Many are PP and/or FSM. It's really not that uncommon in some parts of the country. Bright kids can come from any background, gone are the days you could buy yourself into Uni.

I'm serious if you want to come visit. 'Working class' and poverty are totally different things.

Your last sentence is utterly revolting. So you think the peasants shouldn't mix with the gentry ? Just wow. (Or have I somehow read that wrong - please tell me I have ????)

Unfortunately I don't think you have read it wrong - everyone should keep in their lane. It is like time travelling into the 1950s.

Haven’t read this whole thread, so apologies but l’ve read very many similar. Personally, having a doctor daughter who is 4 yrs qualified I know the struggle. The pay is crap for the responsibility and role. Junior doctors get paid similar to nurses and it’s not right - I speak as a nurse of over 40 yrs. Doctors’ pay in the 80s was nearly twice what I was paid and quite rightly too. That’s taking into account the upshift of what nurses do now.
The biggest shocker is the inability of many foundation doctors to get onto training so they are in limbo or unemployed. This is a big reason for striking, not pay. It’s a disgrace. The govt have now said that they withdrawing the extra 1000 training places as docs are going on strike. My DD said today they weren’t going to be available anyway. They are being made to jump through hoops to apply for limited training places including having to compile a portfolio of published articles, inc teacher training etc - at a big financial cost. Most consultants wouldn’t even have this. I’m furious on their behalf. My daughter is brilliant in her job - caring, dedicated and very competent but she wishes she had done Maths at Uni and would not recommend Medicine as a career. I think the BMA have seriously let junior doctors down over the years to allow the pay to be very much eroded. It’s a case of too little, too late. Those people that think they are being greedy couldn’t be further from the truth.

I think there is a big misunderstanding but in order to clear it up I would like to know more about what you think I mean.

To give it a go: I think high attaining students benefit from a like minded peer group, who value education. Emphatically, this statement has nothing to do with socioeconomic status. My DF was seconded to a very expensive American city for my high school years. We lived in an upscale suburb and i saw first hand that being rich or having high achieving (or pressurising) parents need have nothing to do with valuing education.

So yes, students with talent and ambitions need peers. Also mentors. Where do they get them? Perhaps school can provide this, perhaps not - the needs of the many rightly come before the needs of the few. And the state school teachers and staff I know are doing everything they can already.

I was thinking of the relatively small number of uni outreach experiences in the UK, open to all but at very small scale, or the Sutton Trust and Oxbridge outreach which do focus on pupils from disadvantaged backgrounds but IMO too little, too late. Still a big step in the right direction, however.

A number of independent schools articulate the ideal, but it doesn’t seem to translate to reality: talented, aspiring pupils from different backgrounds have a lot to offer each other . Some could impart confidence and optimism, others tenacity and grit. Different learning styles. Etc. Pupils from different backgrounds should be banding together. I hate that this ideal has deteriorated into a cynical PR exercise.

How can this ideal be achieved? Because state school teachers and staff are so overstretched, my thoughts went to an extracurricular structure. Should or should not independent school pupils be eligible? They may need less help, but socioeconomic segregation is undesirable.

For that matter, one could make a case for focusing enrichment resources on Q1-Q2, because their medical school entry statistics lag so badly, or this could seem wrong on the grounds that it segregates them.

Which would you prefer?

Now I would like to know what you meant in your post?

BTW I was educated abroad in a completely different system.

@Marchesman Your grandfathers and father may have been working class but your DCs attended pre prep, prep, private boarding schools from age 3 to 18, didn't they?

Do you not think the problem lies with a failure of the education system in this country? All children should have equal access to educational opportunities. Then there wouldn't need to be as many contextual schemes seeking to address inequality by trying to level the playing field for those not as fortunate as your DCs? For those who can't afford to or don't want to send their DCs to private schools, the budget in state education whether DCs are in state grammar or comprehensive school don't stretch to afford DCs that level of support. The widening participation schemes exist to address the problem by seeking to level the playing field. It's great that they exist but it would have been better if all children had equal access to these opportunities from the early years of attending school than trying to fix things at age 18.

It has been mentioned here that there are larger numbers of privately educated students going on to achieve firsts at Oxbridge or other elite universities. Maybe not surprising after all that investment in their education. It doesn't mean however that state school or WP students are not as able as the privately educated students. Many are but they are let down by the the educational budgets within the system. It's fantastic that these schemes exist to help WP students access the degrees and universities they want after attaining excellent grades despite facing challenges along the way.

Some posters have suggested that WP doctors are perhaps, in the case of speciality training, not good enough and that's why they haven't qualified for training opportunities and therefore they shouldn't have been doctors in the first place. It's like someone saying doctors from wealthy backgrounds who went to elite universities who are leaving medicine shouldn't have been offered those medical school places if they then leave medicine because they are disappointed they aren't earning as much as their friends who did finance.

The thread has lost focus and little is mentioned about the issues of severe underfunding and replacement of doctor jobs with PAs, etc which is a driver of these strikes.

Also what is happening to locally employed doctor posts that were removed from the NHS to make way for the training places that appear now not to be materialising? There appears to be little concern that future NHS care may be delivered by non-doctors.

I guess just like education, how wealthy you are may determine the healthcare you receive. The patients that can go private will be treated by doctors and those that can't afford to may be treated by PAs and others without medical degrees within the NHS with just a few supervising senior doctors. Without the government expanding speciality training and consultant posts, the future of medical care looks grim. It's absolutely insane that training places are being withheld because strikes are going ahead.

I note there has been discussion on which medical schools make the best doctors. There's no guarantee that doctors who went to Oxbridge or what are viewed to be elite universities deliver the best medical care. Even if the top performers in these medical schools do really well in postgraduate medical exams as you have said, ultimately how good a doctor is depends on many factors including how they deal with patients. Having the best in depth knowledge but a failure to communicate it or being too arrogant to recognise when they have made a mistake or delivered a poor standard of care would be unacceptable to patients. I am sure you would agree that many of the top doctors in the UK, even in the most competitive specialities, have attended medical schools other than Oxbridge.

Doctors set up so much mystique around what they do. It's just a job. There's nothing special about it.

@OonaStubbs LOL, apart from saving lives. As my daughter did today, picking up a grossly abnormal PH on a blood test and getting the patient to intensive care and dialysis.