Escape routes from Medicine

DocDaneka

Hi,
I'm just wondering about the best escape route from Irish hospital medicine. I have decided 20 plus hours per week of upaid work is the last straw. Im just wondering what the best options are. I dont think im cut out for GP (moaning marys drive me mad) so I guess its research, emmigration or private sector something or other. Can anyone tell me of their own particular escapes and how they have got on since ? Thanks.

sam34

how about public health medicine?

DocDaneka

That would be an interesting option. The last 3 doctors who did my job all left to become public health docs. Im afraid I know little to nothing about what phdocs do. What is it like, what are the nasties ? / benefits.

Vorsprung

Australia

/thread


To expand - I left after Intern Year, been in Brisbane since August doing ED, now on the wards. The patient load is better spread out (no more 50 patients between 2 surgical interns), there is always a consultant on hand (in ED they had 5 consultants on the floor during the day - in my old hospital, there were 3 ED consultants in total), and the teaching is excellent. The hours are very managable, 40 hours per week, and most of my time is spent actually practicing medicine as opposed to mundane tasks like running down to Medical Records to get charts.

That said, I will come home in a few years for an SpR scheme but I'd hope that I'd be able to bring some changes in whatever Dept I work in back there, based on what I've seen out here.

What stage are you on the ladder?

DocDaneka

That sounds really good. Im year 2 SPR, dont work in ED though. An A&E i worked in a few years ago a guy came back from AUS full of energy and ideas. He absolutely railed against the practice of first-dose antibiotics (which was causing people without menengitis to go untreated till the poor old admitting sho got a chance to draw up the rocephen). He was called into a room by the consultant and told to shut his mouth - this is the way we do do things here and if you dont like it tough. He was back in AUS within 3 months I hope it goes better for you.

Sitric

DocDaneeka

Are you talking about the time to first dose of ATB's? Is the problem that the first dose has to be hung by the SHO?

I'm currently a 5th yr, thinking about doing my internship abroad, worked in norway last yr and all the younger doctors were talking about what a positive experience it was and how much coordinated training they got (they still had to do rotten hours and a lot of donkey work but without exception everyone found it a good experience)

Jane5

Are you talking about the time to first dose of ATB's? Is the problem that the first dose has to be hung by the SHO? quote from Sitric.

This practice infuriates me no end! It is idiotic, moronic, and cretinous, spawned by some dolt who was both workshy and a simpleton with no understanding of how biological, well, ****, works! Not to shamelessly self promote, but I blogged about this last year when I was at the end of my tether. http://twoweeksonatrolley.blogspot.com/2009/03/inefficiencies-in-irish-health-service.html

That reg from Oz was right to rail about it. More power to him. We all should en masse refuse to do this-but of course, united co-ordinated action from Irish NCHDs is about as likely as finding a ****ing unicorn in Phoenix Park.

ergo

the first dose AB thing is definitely a real bug-bear (is that how it's spelt...?) - don't want to get into a docs vs nurses things but the nurses definitely have the best union - and the fact that it varies from hospital to hospital somehow makes it a bit more infuriating (although giving at least some hope that change might happen eventually)

I've worked in AUS and UK, am now back in IRL - it can be infuriating at times some of the "idiosyncracies" and basic inefficiencies that go on in the Irish system - I'm glad my eyes have been open more to it now though and feel that it's my duty (well, maybe not duty) but it's definitely my goal to try and bring about positive change to the Irish Health system because, well, I think the Irish people deserve it and I want my family to be able to get decent healthcare. How I can do that, well, that's where it gets difficult...

to the OP

it's a tricky one, if you can put up with completing your training are there consultant jobs in your Speciality (are there in any speciality tbh..?)? because obviously you would be getting decent cash then and not working for nothing

GP may not be as a bad as you think, especially if maybe you consider working a 2 or 3 day week with optionally doing the rest in academia (if that's possible) or being a GP with a special interest in something eg Dermatology or something

I'd be curious to know re Public Health

DocDaneka

Thanks for your input. Just back from work , only 6 hours of free labour today, not too bad. Loved your piece on first doses Jane, its a stellar example of how: no matter the stupidity, no matter the cost, no matter the impact on patients - nothing will ever change in Ireland. Someday the HSE management will realise it can cut costs by not feeding patients and that the electricity bill is an extravagence. At least it will save the last doctor left from having to turn out the lights

Think NZ sounds like a plan. There are no consultant jobs in my speciality and if there was one there would be 100 fully qualified applicants for it. Id hate to do someone who would love to be a GP out of a place, even if i could get it. I know so many people who apply desperately every year and dont make it - even final year sprs. I want a life,I think Oceania is the way to get one

MrCreosote

I'd agree with the posts above. One word of warning about Aus/NZ- often the northern hemisphere training is not recognised so you can be at the bottom of the ladder again (like SPR1 level). Not always, but it's a good idea not to burn the bridges in Ireland fully until you're sure where you stand with the Aussie colleges. You could defer a year of the SpR scheme to get "overseas experience" for example, and if Aussie suited just stay on there.

Don't totally rule out the GP thing either! Maybe doing a week or two GP locuming might give a different perspective?

DocDaneka

I can defer a year of the SPR scheme ? Did not know that. I have no qualms about going back to being an SPR1. If I can defer, im out of here come 1st July. I cant get a week off for love nor money, I havent had a holiday in well over a year. Last week off I got, i had call in the middle of it and spent the rest of it finnishing(or trying to finnish) some bloody study. Will phone whoever needs phoning on monday. Which do people recomemend Aus/Nz ? I dont think i want to come back to this mess, so long term where do you i think is better. Thanks

_Whimsical_

I'm not a doctor so I cannot fully relate to where you are coming from but it does sound like you're having a very tough time. You also understandably sound very stressed. Is there anyway that you would consider going to speak to a counsellor or psychologist about all this before you make any definite decisions right now? I'm not suggesting that because I think you sound over the top or anything, just because it's sometimes a bad thing to make life altering decisions from a place of feeling overwhelmed. Of course sometimes it's the best thing you ever did but getting a bit of support or talking it through at length might still help. Good luck with it.

MrCreosote

DocDaneka wrote: »

I can defer a year of the SPR scheme ? Did not know that.

A couple of my friends did a few years ago. Both are back in Ireland. I'd imagine it depends on the exact scheme and how you pitch it. Nothing to be lost from asking anyway.

imported_guy

mind me asking how old you are? if you are still in your 20s just do the USMLEs and go to america, i would prefer that over OZ/NZ, you might be (a little) worse than you are now for 2-3 extra years (residency has long hours/most of them pay less than what most SHOs earn) but things get better, and if you have MRCP done you can get exemptions in residencies for yr1.

anotherlostie

What about going down the legal route and becoming a barrister? Anyone with a medical and legal qualification will do well in the, sadly, ever increasing field of medical negligence.

Dr Galen

that first does antibx thing is a joke, for loads of reasons.

the hospital where i used to work (as a nurse for those who don't know) did not have this policy. Its bloody stupid. For Gods sake on a busy night or day I'd have been waiting for donkeys to get an intern or SHO to make up, check and hang a first doe of Augmentin IV. Something I could do in minutes. Where is the benefit to patient in this nonsense? Really, its a hangover from the old skool, like lots of other things really.

DocD - it seems a real shame you've reached this point. It took hard work, brains and patience to get to where you are now. Don't make a rash decision, think it out. While you didn't get into it to be hanging first dose IVABs, there have to reasons in your everyday that make you remember why you did in the first place. Use those thoughts to get you through the ****ty bits right now and try to make your decisions with a clear head.

Dr Galen

just an aside

there were plenty of times I did need to hang up stuff (first dose) that I wasn't totally sure of. I worked in a fairly specialised surgical area, and sometimes there would be stuff out of leftfield. No disrespect to any of the docs i worked with, but more often than not, the team I worked with didn't have much more notion than me. So who'd we call? Yep, the PHARMACIST. They know all that ****, so if you really wanted to be pedantic, should they not be the ones doing the fecking first dosing?

Svalbard

DocDaneka wrote: »

Thanks for your input. Just back from work , only 6 hours of free labour today, not too bad. Loved your piece on first doses Jane, its a stellar example of how: no matter the stupidity, no matter the cost, no matter the impact on patients - nothing will ever change in Ireland. Someday the HSE management will realise it can cut costs by not feeding patients and that the electricity bill is an extravagence. At least it will save the last doctor left from having to turn out the lights

DocDaneka wrote: »

I can defer a year of the SPR scheme ? Did not know that. I have no qualms about going back to being an SPR1. If I can defer, im out of here come 1st July. I cant get a week off for love nor money, I havent had a holiday in well over a year. Last week off I got, i had call in the middle of it and spent the rest of it finnishing(or trying to finnish) some bloody study. Will phone whoever needs phoning on monday. Which do people recomemend Aus/Nz ? I dont think i want to come back to this mess, so long term where do you i think is better. Thanks

The hospital shop in UCH Galway now stocks bread and milk. Oh dear.

DocDaneka, where the hell are you working that conditions are so bad? Long hours I get, but no hols?!?