Time was it was normal to do 2 years as a Junior House Officer. The six months in medicine and surgery were compulsory, but after that many young doctors in the UK chose to do a further six months in obstetrics/gyn and a further six months in paediatrics.
As a medical student, The Witch Doctor always wanted to be a General Practitioner. However during her first two house jobs she became unsure. The witch doctor hated obstetrics (very scary specialty when things go quickly wrong) so instead she did six months of locums in general practice to help her make up her mind what to do.
So, The Witch Doctor has exactly six months experience of working in general practice. For several reasons, she decided it was not for her but following her experience she has always held GPs high in her esteem. General Practice is not the easiest of specialties and she found it quite lonely – at that time there were many single handed practices.
This was a very long time ago. No training in general practice was necessary. It was possible to enter general practice directly from house jobs.
You will find this difficult to believe………
One morning, The Witch Doctor appeared in an inner city single handed practice to be met by the receptionist-cum-practice-nurse-of-sorts-cum-clerkess-cum-cleaner. The GP had great difficulty getting time off for a family bereavement. He had great difficulty getting time off for anything. It can be safely assumed that his situation was desperate and he was at the end of his tether because, following the preliminary niceties, the first thing the receptionist said to The Witch Doctor was:
“The doctor wants to know if you would be interested in a permanent job with him”
The GP concerned had never met The Witch Doctor and to my recollection had never even seen her CV! An newly acquired MBChB and 1 years house jobs in medicine and surgery were evidence enough of competence. No further post graduate training, no references, no criminal check, no appraisal, and certainly no revalidation.
That is how dumbing down manifest itself in these days!
Recruitment into General Practice followed the law of supply and demand.
Remember the dumbing down that took place during the recent “flu pandemic” when window-cleaners took calls from patients.
“”We pulled the plug on overseas recruitment far too quickly,” said Professor Derek Gallen, who is postgraduate dean of medical training for Wales.
“[We didn’t] realise what the implications of that action would be two, three or four years down the line,” he added.
“Particularly with the European Working Time Directive [and the] increased feminisation of the workforce. These are things that have made staffing rotas very difficult.”
“The deaneries are looking to recruit in areas such as paediatrics, obstetrics, gynaecology, anaesthesia, as well as accident and emergency.”
“The European Working Time Directive, which was fully introduced into the NHS last August, limits doctors to working no more than 48 hours per week and has left gaps on rotas.
Some district general hospitals have had trouble attracting enough staff to cope with the changes leading, in some cases, to services being cut.
In May, the Victoria Hospital in Kirkcaldy had to close its accident and emergency department overnight for a week due to a shortage of junior doctors.
At Erne hospital in Enniskillen, its obstetric and gynecology service had to be suspended for several weeks for the same reason. “
The Law of Supply and Demand should never be forgotten.
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