Medicine 2023 Entry - Part 4

[opoponax]

Anyone out there with DC applying or reapplying for Medicine 2023, please join a friendly thread for mutual support and useful advice.

@Monkey2001 hows your DS getting on at UEA?

Dd is loving it :)

@kackle all good thanks, busy with rugby, cocktail nights, scavenger hunts! Glad to hear your DD is loving it. Very different from the start DS1 had in 2020 when Covid meant that the social experience was so restricted.

Thats great news

We have been so impressed with UEA. Campus is just lovely and its safe.

Dd been on the scavenger hunt too and has hit the onsite nightclub. Her flatmate had a birthday last night so they were off out into town.

She’s made friends and seems happy. We are missing her like crazy but relieved she seems to have settled and enjoying herself.

@mumsneedwine @Monkey2001 My Dd found it fairly easy to pick up locum shifts even fairly early on in the FY programme. And the hourly rates are higher so one shift could compensate for a couple of strike days.

She’s FY3 now, would really prefer to stay in the UK system but getting a training contract for the next stage is not a given. Almost all her medic friends who have just finished FY2 are planning to go to Australia after Christmas also.

Hi @Decorhate , good to hear some doctors want to stay, although I can't help feeling that govt/NHS management deserve to lose them all! I guess that if so many are planning to go to Australia, it will mean those who remain have a better chance of getting a training contract they want where they want it.

@Monkey2001 think the PA positions will increase and there will be less opportunities for doctors. This seems to be the next fight they are going to have.
DD wants to stay. She will do all she can to stay, but the plans are there to go if things don't improve. Being poor was not something she anticipated 6 years ago when she applied.

The PA thing feels extraordinary - how can people with much less experience and more limited authority be paid more and given better opportunities. Mad! I have been advising people considering grad med to look at PA.

@Monkey2001 not sure I would. I don't think the position is sustainable in the long term as patient safety is so at risk. A few high profile mistakes and patients will wise up and demand doctors. I will now (having inadvertently seen a PA instead of GP and they gave me totally the wrong advice - thankfully I knew a doctor to ask 😊). GP was v apologetic.

Even if the roles themselves have been drawn up with effective risk management in mind, the potential for scope creep in a system bursting apart at the seams screams potential for disaster. It sounds like one of those initiatives where people look back and say 'what on earth were they thinking?' but I think that will be the case with a lot that is going on at the moment.

@opoponax I think my DD has been lucky in her first placement as consultants are getting all the F1s into surgery on a rota, and other departments are poaching them too. DD ended up being the main assistant one day (I'm sure there's an official name for this). The PA on the ward seems kind and helpful. Just wanted to be a bit more positive for those just starting out. It's not all bad !

@mumsneedwine there are several reasons I think grads should consider PA:

• less competitive
• better funding (particularly compared to A100)
• better pay in early years, not sure when doctors catch up
• better hours, particularly for parents
• More control over where you are training, which can be more of an issue as people get older and have more personal commitments
• May also be more control over what you specialise in

The downside is that there may be (should be!) a ceiling beyond which you need to be a doctor to progress, both in terms of pay and responsibility. If not, what was the point of doing medicine?!

Just to clarify; all roles have a place in our present NHS and we need them all. We will always need Dr's.
PA's developed in the USA in the 1960's , they work under a Dr's registration, they cannot prescribe and they will only ever earn so much ( there will be a ceiling)
ACP/ANP - often nurses but incorporate pharmacists/ physios/ paramedics have to have a professional body ( ie NMC) , they work independently, prescribe and are accountable for their decisions within their scope of practice. Qualified usually are band 8a ( my background is 30 years of Emergency nursing/practice Nursing/ emergency Nurse Practitioner/ oncology emergency care , educated to MSc level ) They are NOT drs and hopefully don't pretend to be! I also introduce myself as a nurse.
Ceiling is probably 8D band but that is generally management- most top at 8a.
Dr's have a complete different training and they can then specialise it is a tough career but they all are.
Some PA's are crap , some ACP's are crap , some Dr's are crap - most are enthusiastic and put the patient first - I hope all our DC's treat patients/ colleagues with respect- we all have a place.
PA's work under a qualified Dr's gmc number, so the Dr/GP is accountable.
I may have had had a gin so excuse me if I rambled.

@coffeeandbiscuittime it is objectively true that different professionals bring different skills to a team and a well run team will make the best of all the skills and abilities available to it. My understanding is that the main issues with PAs in particular at the moment are that:

• because doctors are on rotational training they often move on to their next rotation just when they get on top of what they have been learning in a given team, whereas PAs are permanent team members, so it is in the interests of permanent team members to train the PAs
• because PAs can't prescribe (yet) doctors have to take on some of their admin burden, so it feels like the doctors are assisting the PAs instead of the other way round
• The additional admin burden means some (many?) doctors are finding they are pushing through ward work whilst PAs are in theatre.
• It is weird that a PA starts on over £40k although they can do less, work fewer hours, generally work more sociable hours
• Some, NOT ALL, PAs behave as if they are doctors

I think that as things currently stand PAs have a significantly better deal than doctors, so if someone wants to control their life/work balance and is not very ambitious, they should seriously consider PA training. I think a graduate would take at least 15 years to catch up financially doing medicine v PA and take the hit on unsociable hours and random locations

NB - I may have been over-influenced by Reddit, but it seems to have enough truth. The finances are objective.

I think you have summarised it well @Monkey2001 I’ve also seen some disquiet being raised about more specialised associate posts such as Anaesthesia Associates. That’s the area my Dd wants to get into but very competitive for actual doctors to get a training programme & bottlenecks further along too. I do wonder if it’s a government ploy to save money ultimately

@Decorhate as PAs earn much more money than doctors, for many years, cost saving doesn't seem to be the issue. The government just seem to hate doctors. PAs can't leave and go abroad as not skilled enough.
I really hope the public start to wake up as to what is happening. Surgical PAs are being told they can perform solo operations, something it takes a doctor 10+ years post graduation to do. PAs have a 2 year degree. It's all mad.

@mumsneedwine I think doctors made a mistake when they chose not be part of the Agenda for Change pay scales. If jobs were being scored on the same points basis, F1/F2 doctors would get their 35% if on A4C, and I assume the pay differentials driven by the scoring system would mean that most doctors would be very well.

@Monkey2001 I think the old BMA have a lot to answer for ! The new BMA are awesome.
I knew nothing about previous negotiations but seems the doctors were cheated out of pay and some decent treatment. Just don't understand why the government won't negotiate - it makes no sense as they are not going to just give in.

How are everyone's young people getting on in 1st year?

My DD is drowning with the workload. She does have a part time job she was keen to keep but at weekend had a meltdown as not enough hours in the day to do all her uni work on top of part time job. I think the job will need to go or drastically reduced hours to one shift per week. I'm sure this won't go down well with her boss.

Freshers week was wild and out every night. She had the time of her life.
Since then has been out once a week only as uni so full on. It's very intense. She had been warned and says she's still loving it. Don't think she thought it would be as all consuming.
She has no time to meet up with other friends who are out all the time. Says they have fallen out with her as she declined nights out with them but went to the organised medsoc nights!
She was told by a lecturer to make sure she makes friends with ones on her course as they are only ones who will understand the pressures.
She seems happy with her course but overwhelmed.

Yes the workload is fairly intensive and she too is mainly making friends with other medics but still really enjoying it. I guess it makes sense, they will be there for longer. She is still managing her hobby. Fortunately work is holiday time only so that is not a factor.

My DD is loving it and doesn't feel too pressured with the workload yet, maybe that will come.

How many hours is she working? Is that at home (i.e. is she coming home to go to her part time job) or is she commuting back - that will take time too.

I think it would be tricky to have a job / study / medicine / make time for friends & freshers etc at the start. Could she perhaps just work in the holidays?

My DS is finding it heavy going too. He is mainly socialising with medscoc which seems very welcoming. But he is managing uni wide choir and a hall based football six a side league.
But the reality of 6 hours of lectures a day plus preparing for anatomy sessions and writing up notes is becoming a little over whelming.
He had a blast in freshers week, out a lot, but has had to pin that right back.

My DS also thriving. Had a busy Fresher week, then came down with Fresher Flu. He is also exhausted and falling a bit behind on work, but is on the case. Medics rugby seems to be his main "thing", it is quite a commitment as they have a practice session and a match every week and social every couple of weeks, and matches involve travel. He also has a choral scholarship and managed to make it for the morning service on Sunday, but fell asleep when he got back and missed evensong. I think he will have to give himself a curfew!

My dd hasn’t really
started properly yet. I suspect the workload is gojng to ramp up very quickly! The medic societies are brilliant and very welcoming of my dd.

Yes -DD enjoying but the ‘12 weeks of hell’ PCS at Cardiff has truly kicked in!

So how is everyone coping?
My DD has found a house for next year, she appears after a wobbly start to be settling in.