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UK Medical Careers Research Group

Submitted by orion on Wed, 2006-12-20 17:05. | | | |

Introduction

I received this survey in the mail today - "Calling all 1999 Graduates" - it said. I've taken part (kind of: I can't remember returning all the forms) in the past surveys, and this is the most recent one to come out. I guess in part that I have always been ambiguous about the responses: it's very hard to know how to reply to a single-response questionnaire, when really you (one) wants to put several choices, and justify them.... Anyway, am filling in the current one and, as usual, there's not enough space, so thought I'd put additional comments on here.

Career Preferences and Experiences of Doctors who Qualified in 1999 - 2006/7 Survey

Have you made up your mind about your choice of long-term career?
Probably
What is your choice of career?
Paediatrics and Epidemiology [equal preference]
How much has each of the following factors influenced your career choice?
Not at all A little A great deal
wanting a career that fits my domestic circumstances X
Wanting a career with acceptable hours/working conditions X
Experience of chosen subject as a student X
Enthusiasm/commitment: what I really want to do X
Self-appraisal of own skills/aptitudes X
Inclinations before medical school X
Future financial prospects X
A particular teacher/department X
Advice from others X
Experience of jobs so far X
Career and promotion prospects X
Other reasons*
*If 'Other reasons' influenced your career choice, please give details of those reasons
I want to do some kind of intensive medicine - probably to do neonatal intensive care. But, better to describe it as "Neonatology" as this also encompasses the "prophylactic" aspects of seeting a baby and family up for life. I have always had an interest in epidemiology (since medical school) and the health of populations recognising that it is political and not medical interventions that have the greatest impact on health outcomes. But that isn't so sexy, is it?

Apart from temporary visits abroad, do you intend to practise medicine in the United Kingdom for the foreseeable future?
No - definitely not.
If you did not answer 'Yes-definitely,' what are you considering?
Practising medicine abroad
What is your main reason for planning to do so?
Big question! I took a bit of a career break from UK medicine (although not, per se, from medicine) and practised in Australia for a year before taking further time out to look after an elderly relative with Alzheimer's Disease in the United States. Upon returning to the UK, I was given false information that a job I was taking was a training post (it wasn't) and I've subsequently been overtaken by MMC - Modernising Medical Careers: in which junior doctors are meant to have a streamlined pathway from medical school through to consultantship. It is has thus been extremely difficult to get back onto the 'training ladder' and I find myself leapfrogged by enthusiastic (although, ultimately, probably boring - as they've not had as broad life-experience) younger doctors who are within the system and not only prepared but have also been coached for the current changes. Instead, MMC did not begin until after I left the country (the proposal was made in the summer of 2003, which is when I last worked here in a training capacity) and has been rushed through in all the time I have been away or out of touch (the last unit where I worked been a super-specialised unit which did not really have any connection with the general paediatric world whence I came).
Which country or continent?
United States of America
Do you feel committed to a long-term career in the NHS?
No - probably not
If you did not answer 'Yes - definitely,' what changes to the NHS would increase your commitment or encourage you to return (if you have left)?
The NHS no longer appears to be committed to both high-quality patient care and to training good doctors, but seems to serve a single purpose of fullfilling political agendas only. The current changes may be creating a better environment at the present time for patients, with an emphasis on more senior, more experienced doctors managing patients, but ultimately what this is doing is deskilling junior doctors such that they will only gain adequate experience when they are more senior. Overall, I can only see roles being relabelled - no longer 'Registrar' and 'Senior Registrar' as it was 10 or 15 years ago, but now 'Specialist Training Registrar' and 'Junior Consultant'.
Your career and training: Please consider each statement and mark how accurate it reflects your own opinion
I have had good career opportunities in my career to date Agree
I am happy with my present position Disagree
I am satisfied with my future career prospects Strongly disagre
Making career choices has been made difficult by inadequate careers advice Strongly agree
The postgraduate training I have received so far has been of a high standard Neither agree nor disagree
The limits on working hours imposed by the European Working time Directive have had an adverse effect on my training opportunities Strongly agree
The requirements of the European Working Time Directive with regard to working hours are in my experience strictly observed Strongly agree
The provision of on-call rooms and study areas has worsened since the implementation of the European Working Time Directive Strongly agree
Generally speaking, GP training in the UK is of a higher quality than training in the hospital specialties Agree
Your recent employment history. Please give details of you current employment and all completed periods of employment since October 2004 starting with the most recent and working back. Please also tell us about any periods of time greater than a month not in paid employment (including maternity leave).
Not provided here
Additional comments. Please give us any comments you wish to make, on any aspect of your training or work. Use continuation sheets if necessary. We are particularly interested in any comments you may have on your experiences so far of good and bad features of your training, working conditions and working environment; professional relationships; and administrative and managerial issues. Your individual comments will remain totally confidential to senior researchers in the UK Medical Careers Research Group.
Not provided here

Conclusion

Maybe I should have called this section 'Discussion.' I don't know that I have any conclusions - apart from medicine in the UK is sorely broken at the moment, and doesn't show any signs of being fixed soon. At least, that is the way I see it. For medicine is composed of two parts: fixing people, making them better - the service component; and teaching people, helping them to help others - the education component. Medicine is, alas, not a quick fix solution for anything: that lies in politics and political solutions, long term planning (dare I say?), and there is none of that being shown at present. Instead, what we get is short-termism. Quick fixes that make governments look good and enable them (they hope!) to stay in power, in favour with the populace. Currently, it seems that many of the remedies of the previous governments - John Major's and Margaret Thatcher's governments, the Tory era - are being fixed, but that is just an illusion. Many new, young doctors, some on the dole. But it takes time to train doctors and the UK is falling foul of the age old problem of predicting growth.

More on this later, I guess... this topic needs to be expanded. Suffice to say that, whilst medicine today may be adequate, there will be severe problems in the future from what we are creating.

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