Apprentice Doctors

[islandgun]

Any thoughts ?

https://www.thelondoneconomic.com/news/nhs-radical-change-allows-school-leavers-to-practise-medicine-without-a-degree-348202/ 

[London Best]

What could possibly go wrong?

[discobob]

Hello, I will be carrying out your brain surgery today as I need it to complete my BTEC module...🤣

[Genghis]

Provided it's made clear that the Doctor that you'll be seeing will be an apprentice, then I don't see the problem.

 

In this day and age, it's far more rewarding to society that they do this than spend years in university.

[welsh1]

When i go to my doctors surgery it is rare i see a Doctor, i am normally dealt with by a Nurse practitioner who can write prescriptions, and a few weeks ago when i could not get a doctors appointment for an ear infection i saw a Pharmacist who could diagnose and prescribe.

It's not a great leap for the above people to take the next step to fully qualified Doctor.

If you train or work in a medical setting why not take an apprenticeship and over the years work toward being a qualified doctor? i doubt that an apprentice will be doing anything life threatening without a qualified person overseeing them.

No Doubt they will weed out people who don't have the skills required to be able to complete the course at a very early stage.

[harkom]

From my own personal experience, if (when) the receptionist offers an appointment with the student/apprentice I would advise that you politely decline and request to have an appointment with one of the "regular " (?) practice GPs - despite the receptionist offering an earlier date with the former. It will save you a lot of time and angst.

 

[loriusgarrulus]

"NHS: Radical change allows school leavers to practise medicine without a degree"

The headline is just sensation seeking like most news articles. 16-18 year olds are not going to practice medicine without training. 🤷‍♀️

 

Years ago nurses did what amounts to an apprentice placement learning on the job with classroom learning as part of it. Starting at the bottom doing the dirty jobs and gradually learning and taking on more complex tasks under supervision till they could do them on their own.

Recently going to university, getting a degree and a load of debt before getting in at the dirty end and finding it doesn't suit puts many off. 

If a Doctors apprenticeship scheme works the same way it could be the way forward. Supervision till they are competant, with constant assessment and weeding out of the unsuitable. The mixture of practical under supervision and classroom learning with assessment and exams opens up the way to many who are put off from starting their working life with a mountain of debt.

It does state  further down the article that A level leavers could apply and so would still have to have a certain educational standard and interviews before getting accepted on the scheme like any apprenticeship. 

Way to go definatley. 

 

[ph5172]

Could they not just give the receptionists another weeks training. They way they all act when you call they all have medical degrees anyway 

[harkom]

1 hour ago, loriusgarrulus said:

Recently going to university, getting a degree and a load of debt before getting

...on a 'plane to a job in Aus, NZ, US, CAN.......

[Westward]

I'm in that minority that doesn't think doctors are elite. specially gifted human beings that should be worshipped as being near godlike. This is why I'll never again put unquestioning trust in the opinion of a doctor, whether one with 7 years of university training or a 3 year apprenticeship.

As I've said before I am being treated for metastatic prostate cancer. 2 consultants have told me that it's not curable and life limiting. In 2013 I had a check up and blood test at the surgery with the senior GP at which I specifically requested a PSA test. There was no follow up call and I assumed everything was okay. The following year I had another check up but this time the practice nurse took blood before I saw the doctor. She was looking at the screen and asked if the doctor had mentioned my PSA result from the previous test as she thought it was rather high. He hadn't. A week later I saw a different doctor for the physical exam and asked him about my PSA. From what he said I now know that back then my PSA was abnormally high but he asked a couple of questions about my peeing habits and that was that until my cancer diagnosis in January 2022. But I never forgot the actual figures from back then.

A few weeks ago I remembered those 2 blood tests from 9/10 years ago and what's more I could recall the actual figures quoted by the 2nd doctor, so I requested and got access to my GP health records via the NHS app. Imagine my surprise when I found that the entries for the 2013/14 PSA tests had been redacted on 24th January 2023. In the last week the results have been redacted again eliminating all PSA results, even one from 2 months ago. What this means is that not only were the doctors negligent in the extreme by not following up the earlier abnormal tests, but now they've managed to erase the evidence that proves it! 

I can't prove which doctor erased the results which is a shame because it's a criminal offence to change factual information on a patient's record. Legally, a doctor can only modify their own opinion and only in certain specific circumstances.

 

[TIGHTCHOKE]

Good grief, very sorry to hear how you have been treated and to find out "they" have managed to wipe out all the evidence is beyond contempt.

[Pushkin]

No issues with this.  It will be a fully supervised model of qualified accompanied by apprentice and decisions will be made by the Doctor not the apprentice.  Just like apprenticeships used to be and also doctor training was very much in the same boat.  They only get to take responsibility when they have shown they are experienced and fully understand the outcomes.  

 Pushkin  (PS doubt it will be a 3 year apprenticeship - more likely a 7 year one and possibly even longer)

[London Best]

11 hours ago, Westward said:

I'm in that minority that doesn't think doctors are elite. specially gifted human beings that should be worshipped as being near godlike. This is why I'll never again put unquestioning trust in the opinion of a doctor, whether one with 7 years of university training or a 3 year apprenticeship.

As I've said before I am being treated for metastatic prostate cancer. 2 consultants have told me that it's not curable and life limiting. In 2013 I had a check up and blood test at the surgery with the senior GP at which I specifically requested a PSA test. There was no follow up call and I assumed everything was okay. The following year I had another check up but this time the practice nurse took blood before I saw the doctor. She was looking at the screen and asked if the doctor had mentioned my PSA result from the previous test as she thought it was rather high. He hadn't. A week later I saw a different doctor for the physical exam and asked him about my PSA. From what he said I now know that back then my PSA was abnormally high but he asked a couple of questions about my peeing habits and that was that until my cancer diagnosis in January 2022. But I never forgot the actual figures from back then.

A few weeks ago I remembered those 2 blood tests from 9/10 years ago and what's more I could recall the actual figures quoted by the 2nd doctor, so I requested and got access to my GP health records via the NHS app. Imagine my surprise when I found that the entries for the 2013/14 PSA tests had been redacted on 24th January 2023. In the last week the results have been redacted again eliminating all PSA results, even one from 2 months ago. What this means is that not only were the doctors negligent in the extreme by not following up the earlier abnormal tests, but now they've managed to erase the evidence that proves it! 

I can't prove which doctor erased the results which is a shame because it's a criminal offence to change factual information on a patient's record. Legally, a doctor can only modify their own opinion and only in certain specific circumstances.

 

In 1979 I had hepatitis. I can’t remember which type, but I was still having problems two years later. 
There is no mention of this in my medical records.

[welsh1]

23 minutes ago, London Best said:

In 1979 I had hepatitis. I can’t remember which type, but I was still having problems two years later. 
There is no mention of this in my medical records.

in 1991 i had lots of injections while out in the Gulf with the Army, years later when i left the Army my medical records were transfered to my local doctor i had registered with, i had no medical records at all from when i joined in 1983 until 1992, nothing at all. My medical records are buried in a big hole in the desert along with many others who were given the various injections for anthrax ,plague etc.

 

[DUNKS]

I am all for this. A well intentioned intelligent school leaver could not possibly make a worse job of running a doctors surgery than the clowns I have to suffer.

Me at pharmacists. Why are all the items on the repeat prescription not here?

Pharmacist. Sorry you will have to see your doctor.

Reception at doctors. Sorry no appointments in the foreseeable future but I will pass on your concerns.

Doctor phones me next day to say that I cant just decide to START taking prescribed medicine without a doctors authority. Make an appointment to see a doctor.

I have been on the same repeat prescription for four years.

[discobob]

6 minutes ago, welsh1 said:

in 1991 i had lots of injections while out in the Gulf with the Army, years later when i left the Army my medical records were transfered to my local doctor i had registered with, i had no medical records at all from when i joined in 1983 until 1992, nothing at all. My medical records are buried in a big hole in the desert along with many others who were given the various injections for anthrax ,plague etc.

 

My back got damaged while on a training exercise when the driver of the landrover (110  6 man det with an extra man in the back) decided to raise across a rough field. I was sat in an awkward position next to the clansman and got threw up in the air and slammed down (I also hit my head on the roof) and ended up medivac'd off the exercise and suffered ever since with it (I ended up with a 19% disability and a lump sum) however my letter to the civvy doctor on discharge said I had a car accident in 1990 and suffered with back problems since then - I had some whiplash after the accident, not L5/S1 kaput

[oldypigeonpopper]

Hello, they say GP s are leaving in droves so fewer GP s to look after twice as many patients, my surgery is down by 4 GP s , GP s are saying they are over worked and stressed out , well if GP s did not leave surely there would be enough to look after all patients, and not get over worked 🤔

Edited May 11, 2023 by oldypigeonpopper

[GHE]

13 hours ago, Pushkin said:

No issues with this.  It will be a fully supervised model of qualified accompanied by apprentice and decisions will be made by the Doctor not the apprentice.  Just like apprenticeships used to be and also doctor training was very much in the same boat.  They only get to take responsibility when they have shown they are experienced and fully understand the outcomes.  

 Pushkin  (PS doubt it will be a 3 year apprenticeship - more likely a 7 year one and possibly even longer)

I agree. And the current situation is far from satisfactory anyway, newly-qualified doctors need a very high level of supervision but the workload doesn't always allow it to actually happen. One of the things that alarms me is the mantra "See one, do one, teach one" which basically means that a doctor watches an experienced colleague carry out a procedure once, and can then do it themself next time around, and can then teach others to do it - not good for patients!

1 hour ago, oldypigeonpopper said:

Hello, they say GP s are leaving in droves so fewer GP s to look after twice as many patients, my surgery is down by 4 GP s , GP s are saying they are over worked and stressed out , well if GP s did not leave surely there would be enough to look after all patients, and not get over worked 🤔

The real problem is that GP doctors are so highly paid that they don't want or need to work full-time, which adds to the problems. 

[Westward]

By far the best people I've dealt with in the NHS are the Nurse Practitioners. There's a lot of contact with the NPs when having a course of Chemo and in my experience they've always been thorough, helpful, considerate and professional.

It's not just Joe Public who think GPs are taking the rip, ask a nurse in the Chemo ward what they think about GPs and GP pay. I did and I got a very clear answer because they know that every day they're providing hideously expensive treatment to people who, in many cases, wouldn't have ever got to that stage if their GP had taken their symptoms seriously and when less costly and more effective treatment would have been prescribed.

Cancer is on the rise and by 2035 at the present rate, 70% of the population can expect to be diagnosed with cancer at least once in their lifetime.

There are thousands like me who should have been diagnosed years earlier but weren't because their GP was too lazy/disinterested/incompetent/negligent/inattentive etc. to do the job for which they are very, very highly paid. As said above, it's bad enough that they get so much wrong, but the fact that they try to hide the evidence shows just how low they really can get and little they really care about their patients.

[Lloyd90]

This thread just shows why GP‘s are leaving in large numbers. 
 

1. Blaming the fact that they are short staffed on themselves.
How dare they go to other countries like Australia, there they can earn about 2-3x the wages they can here, not to mention the many other benefits of moving there. Lower workloads, different cultures to work etc. 

2. Blaming GP’s for the way testing for conditions is managed. 
How we run frontline services and testing is done by Policy makes and budgets. 
On this forum we have in the past had members talk about their experience in France where you go in with a minor condition and they run every test going just in case. That’s a policy across the board and a culture of treatment. I can’t see how individual GP’s would be blamed for that. 
Our testing facilities etc are already massively overrun and underfunded without us having a policy like this. 
 

3. GP’s being called lazy and getting general abuse. Amazing. And the view that because they are on more money than the majority of the public they can’t complain about wage deflation and cuts etc.

If you can’t earn very good wages as a Doctor then where can you?! It’s only only of the top professionals in the world!  
 

Not surprised at all that they are going abroad in droves and can only see it getting worse. 
 

 

What’s worse again, is that nurses years ago just gave you a wash and some very basic care, nurses these days are providing care and doing procedures that in the past Doctors would do, or those procedures wouldn’t even exist. 
 

The idea we can do away with university educated nurses and just fly them all through apprenticeships to cover up the fact the NHS is crumbling is madness. 
 

The NHS is a black hole for funding and will probably never get sorted out. 
 

If it was up to me I’d do away with a massive amount of the stuff the NHS covers. 
 

No more IVF, if you can’t do it naturally that’s the luck of the draw, or to private. 
 

No more gender reassignment, especially for kids for Christ sake. 
 

No more cosmetic procedures, even if they do pretend it’s “effecting my mental health”. 
 

And unfortunately stop things like major procedures on people who are in the last years of their lives anyway. 
A new hip that’s good for 20+ years ain’t value for money to be given to an 85 year old whose life expectancy is less than 1 year post op. 
 

In 2021/2022, 50% of NHS budget was spend on prescriptions. 
 

Again, we have millions of 80+ year olds who are only being kept alive by the 50+ pills they are popping daily out of their medication dispensers. Many of them sat in care and nursing homes just waiting to die. 
 

But the NHS government can’t say “stop their medication” cos they know they’d likely not last long without and are terrible of the blame game that has infected Government and healthcare. 

[welsh1]

14 minutes ago, Lloyd90 said:

T
 

And unfortunately stop things like major procedures on people who are in the last years of their lives anyway. 
A new hip that’s good for 20+ years ain’t value for money to be given to an 85 year old whose life expectancy is less than 1 year post op. 
 

In 2021/2022, 50% of NHS budget was spend on prescriptions. 
 

Again, we have millions of 80+ year olds who are only being kept alive by the 50+ pills they are popping daily out of their medication dispensers. Many of them sat in care and nursing homes just waiting to die. 
 

But the NHS government can’t say “stop their medication” cos they know they’d likely not last long without and are terrible of the blame game that has infected Government and healthcare. 

One day you may be that 80+ yr old.
Be interesting to see if you will have changed your mind by then.

[Lloyd90]

2 minutes ago, welsh1 said:

One day you may be that 80+ yr old.
Be interesting to see if you will have changed your mind by then.

 

At 80+ years old, if I am still alive, if I am of sound mind, body and cognition I will undoubtedly want to continue to be alive.

But at what cost? 

I see many many people every week who tell me they'd rather pass away in their sleep than be sat soiling themselves in a care home, dribbling and not knowing what is even going on around them. 

Many of those people would have passed away, in their sleep or otherside, from heart attack, stroke, or any other conditions, but the 50+ pills a day are holding off that.

Why?

It is perfectly natural to die when in old age. 

 

When my time comes it comes, there's nothing any of us can do about it.

I have been out and seen many people in nursing homes who are 24/7 cared for in bed, they are tube fed, all medication done through IV lines, totally comatose, but the Doctor overseeing their care continues to "treat them" and keep them alive in this way. 

I remember the family pleading with the Doctor to let them slip away but the Doctors refused and just wanted to keep them going ... 

For what purpose? 

 

 

 

 

[welsh1]

18 minutes ago, Lloyd90 said:

 

At 80+ years old, if I am still alive, if I am of sound mind, body and cognition I will undoubtedly want to continue to be alive.

But at what cost? 

I see many many people every week who tell me they'd rather pass away in their sleep than be sat soiling themselves in a care home, dribbling and not knowing what is even going on around them. 

Many of those people would have passed away, in their sleep or otherside, from heart attack, stroke, or any other conditions, but the 50+ pills a day are holding off that.

Why?

It is perfectly natural to die when in old age. 

 

When my time comes it comes, there's nothing any of us can do about it.

I have been out and seen many people in nursing homes who are 24/7 cared for in bed, they are tube fed, all medication done through IV lines, totally comatose, but the Doctor overseeing their care continues to "treat them" and keep them alive in this way. 

I remember the family pleading with the Doctor to let them slip away but the Doctors refused and just wanted to keep them going ... 

For what purpose? 

 

 

 

 

My Dad was a fit Veteran who in his mid 40's had a lot of health problems leading to him having to retire very early, a cocktail of tablets kept him alive and he led a good life, in his last 3 years he was told he had weeks to live as he had leukemia or at best 2 years with treatment, he chose the treatment he lived 3 more years, he got to see his last greatgrandchild and held her in his arms, would you have deprived this old man his treatment?

After fighting for 3 years it took a toll on him physically and mentally and he decided that he would have no more treatment he died a couple of years ago.

We all know what Mcmillan nurses do ,we all know what pathway protocols there are out there.

I do agree with you that we treat death with a sense of fear and may keep loved ones hanging on for our own benefit, but there is a slippery slope to be had and it needs proper debate and thought.Once you look at the old in a comatose state do you then look at the young, infirm, disabled.Looking at Canada and Belgium and their euthenasia laws they seem to have "mission creep" and slowly add more and more to their policy.

Having come close to death on a few occassions i don't fear it and it is well known in my family what should be done or not done if i am incapable and have no viable chance of coming back.

[GHE]

Lloyd 90, you've made some good points.  Of course they're entitled to go abroad to work, my own daughter (a midwife) did the same, far more pay, she was met at the airport and taken shopping, then driven to a nice house that was hers rent-free for the first 6 months, then she was given the contact details of the 8 hospitals in her area that she could interview . . . but at least she worked here  for long enough to give something back, after all those years of expensive training.

I think that one of the problems in the UK is that there is still the problem that attitude towards medical doctors are something very special, which from my own experience goes back to the very early days of the NHS (and beyond) when they were doing people a massive favour just by seeing them, fitting patient care into their 12-hour day and hoping not to get too many night calls on top . . .  How things have changed!

Many countries do things very differently.  I have diabetes and once needed urgent treatment while I was in China. Just go to the nearest hospital, no appointment needed. A complete medical check, starting with a blood test, and followed by diagnosis and immediate treatment. Very impersonal, a complete production line but highly efficient. The check cost £30 and the treatment was another £12. How was my Mandarin? Poor, but I didn't need it as all of the doctors and most of the technicians spoke decent English.

A friend's father is a doctor in one of these hospitals, he only sees children aged between 7 and 9, he spends all of his working time doing so and because of this he is a real expert at diagnosing them and then passing them on to the appropriate department. He is regarded as, and paid similar to, any other skilled craftsman. Not that Chinese medical care is perfect, in particular they have only just begun to recognise mental health as a problem and have a long way to go in this area.

I do take your point about keeping people alive unnecessarily, but the reverse of that coin is that I had a minor heart attack last year and expected to be written off because of my age, but have received excellent care from everyone except my GP.

[discobob]

ignore - editor messed up

 

Edited May 11, 2023 by discobob