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The NCHD Training Grant
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I find it interesting the extremely hostile reaction NCHD2010 is geting here and on the other thread. While I certainly think he is clearly overplaying the 'Jenny from the Block' line, he does make a few valid points. But from the reaction he is getting, it is as if he is a complete troll whose points are completley unfounded.
On the two central point(s):
1. Training: it is far from universal in other professions for employers to pay for the training costs of their staff. For instance, most solicitors firms do not pay for Blackhall place fees, or for the attendance at courses, further diplomas etc once qualified. I suspect it is similar with accountancy etc. However, the situation in medicine has always been a bit different in that the access to training has always been essentially controlled by the State (ie. almost all of the training posts are public jobs) and therefore one could argue that there is more of an onus on the State to cover training costs (than say, an individual law firm). But the point is that an argument to the effect that NCHDs should cover all, or some, of their training costs is a reasonable argument to make. One may disagree with it, but from the reaction of many here, one might think that the argument is entirely unsustainable and without precedent. It isnt.
2. Hours: The fact that NCHDs are still doing shifts of 48-72 hours is entirely inexcusable and any attempt to do so is bogus. But you have to ask yourselves wtf ye have been doing for the last 10 years. There was serious momentum in 2000; but ye all sat on your asses and did nothing further. It really is baffling; and sadly, NCHDs only have themselves to blame. And despite all the talk, 10 years later, you see the exact same words being spoken in exactly the way they were in 2009 & 2008 & 2007 and....... yet there hasnt been any real substantive change at all.
NCHDs are, and always have been, world-class experts at moaning - about the employer, about each other, about the patients, about everyone else having such an easier life than them - but are woefully inept when it comes to doing something about it. As there is no doubt that NCHDs as a bunch are some of the most capable people in the country, the only reason why they are incapable of acting with some kind of purpose to end such ridiculous work practices is because, sadly, of the incredible selfishness of many of their number. NCHD2010 may attract your ire for being reluctant to rock the both on hours/work practices but at least he's honest; the rest of ye seem to be like almost every one of the other few thousands NCHDs who have gone through the system in the last 10 years; plenty of talk, next to no action.0 -
Drkpower
You say Ye as thou you are not an nchd?
What is your position if I may ask?0 -
Pastafarian wrote: »Drkpower
You say Ye as thou you are not an nchd?
What is your position if I may ask?
Ex-nchd. No longer in the profession:):p.0 -
Join Date:Posts: 11109
Hi Drkpower
The first point is I think missing the point. NCHD posts are paid less than positions purely for service because they are (nominally at least) training posts. Thus the lower pay rate (as opposed to consultants here and staff grade positions in the UK) is supposed to reflect the fact they will be trained while in post.
While the Training Grant which my generation fought for has been lost now. GP training specifically has been changed quite dramatically by the actions of NCHD's over the past few years. It's a bit unfair to accuse recent NCHD's of doing nothing.
NCHD2010 's valid points are really drowned out by his/her trolling. Any validity they have is hard to say as they are usually surrounded by a litany of poorly informed comment and attempts to irritate other posters.
He/she really is at fault for the responses purely because they're acting like a muppet :rolleyes:I find it interesting the extremely hostile reaction NCHD2010 is geting here and on the other thread. While I certainly think he is clearly overplaying the 'Jenny from the Block' line, he does make a few valid points. But from the reaction he is getting, it is as if he is a complete troll whose points are completley unfounded.
On the two central point(s):
1. Training: it is far from universal in other professions for employers to pay for the training costs of their staff. For instance, most solicitors firms do not pay for Blackhall place fees, or for the attendance at courses, further diplomas etc once qualified. I suspect it is similar with accountancy etc. However, the situation in medicine has always been a bit different in that the access to training has always been essentially controlled by the State (ie. almost all of the training posts are public jobs) and therefore one could argue that there is more of an onus on the State to cover training costs (than say, an individual law firm). But the point is that an argument to the effect that NCHDs should cover all, or some, of their training costs is a reasonable argument to make. One may disagree with it, but from the reaction of many here, one might think that the argument is entirely unsustainable and without precedent. It isnt.
2. Hours: The fact that NCHDs are still doing shifts of 48-72 hours is entirely inexcusable and any attempt to do so is bogus. But you have to ask yourselves wtf ye have been doing for the last 10 years. There was serious momentum in 2000; but ye all sat on your asses and did nothing further. It really is baffling; and sadly, NCHDs only have themselves to blame. And despite all the talk, 10 years later, you see the exact same words being spoken in exactly the way they were in 2009 & 2008 & 2007 and....... yet there hasnt been any real substantive change at all.
NCHDs are, and always have been, world-class experts at moaning - about the employer, about each other, about the patients, about everyone else having such an easier life than them - but are woefully inept when it comes to doing something about it. As there is no doubt that NCHDs as a bunch are some of the most capable people in the country, the only reason why they are incapable of acting with some kind of purpose to end such ridiculous work practices is because, sadly, of the incredible selfishness of many of their number. NCHD2010 may attract your ire for being reluctant to rock the both on hours/work practices but at least he's honest; the rest of ye seem to be like almost every one of the other few thousands NCHDs who have gone through the system in the last 10 years; plenty of talk, next to no action.0 -
I find it interesting the extremely hostile reaction NCHD2010 is geting here and on the other thread. While I certainly think he is clearly overplaying the 'Jenny from the Block' line, he does make a few valid points. But from the reaction he is getting, it is as if he is a complete troll whose points are completley unfounded.
On the two central point(s):
1. Training: it is far from universal in other professions for employers to pay for the training costs of their staff. For instance, most solicitors firms do not pay for Blackhall place fees, or for the attendance at courses, further diplomas etc once qualified. I suspect it is similar with accountancy etc. However, the situation in medicine has always been a bit different in that the access to training has always been essentially controlled by the State (ie. almost all of the training posts are public jobs) and therefore one could argue that there is more of an onus on the State to cover training costs (than say, an individual law firm). But the point is that an argument to the effect that NCHDs should cover all, or some, of their training costs is a reasonable argument to make. One may disagree with it, but from the reaction of many here, one might think that the argument is entirely unsustainable and without precedent. It isnt.
2. Hours: The fact that NCHDs are still doing shifts of 48-72 hours is entirely inexcusable and any attempt to do so is bogus. But you have to ask yourselves wtf ye have been doing for the last 10 years. There was serious momentum in 2000; but ye all sat on your asses and did nothing further. It really is baffling; and sadly, NCHDs only have themselves to blame. And despite all the talk, 10 years later, you see the exact same words being spoken in exactly the way they were in 2009 & 2008 & 2007 and....... yet there hasnt been any real substantive change at all.
NCHDs are, and always have been, world-class experts at moaning - about the employer, about each other, about the patients, about everyone else having such an easier life than them - but are woefully inept when it comes to doing something about it. As there is no doubt that NCHDs as a bunch are some of the most capable people in the country, the only reason why they are incapable of acting with some kind of purpose to end such ridiculous work practices is because, sadly, of the incredible selfishness of many of their number. NCHD2010 may attract your ire for being reluctant to rock the both on hours/work practices but at least he's honest; the rest of ye seem to be like almost every one of the other few thousands NCHDs who have gone through the system in the last 10 years; plenty of talk, next to no action.
I appreciate your point, drkpower, but you have left the NCHD world behind, and, no disrespect intended, but it's far easier to say what you did when it's no longer a problem you face every day. Most NCHDs, especially the ones that are a few years in, rely on their jobs for a living, have mortgages, families, expenses that younger, single NCHDs and interns may not have.
I would feel better about rocking the boat as an individual if I were a younger NCHD, unmarried, with no commitments, and did not have so much invested into this, and not be relying on it for my income as I do.
I do occasionally try to organise us to stand up for ourselves, and on one occasion, got a solicitor to force the hospital to pay our training grant to us when they were refusing-nearly five years ago now, time flies! Paid for him myself, and I think when they paid back the grant I was still out of pocket, but I was making a point.0 -
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I agree with you Rob, in may respects and yes, when I say 'nothing' obviously I am engaging in a little exaggeration myself. Of course there have been changes in a decade (the most proisperous of the countries history), anything less really would be inexplicable. But to be honest, the fact that there are still NCHDs working 48-72 hours is an incredible stain on the reputation on anyone who is now, or was an NCHD in the past 10 years and did very little to change it.
And on your training point, I agree, I briefly alluded to the slightly unique position of medical training. All I am saying is that payment for external courses, attendance at conferences, exams etc is not something that goes without saying. Strictly speaking, the training to which you refer is the on-the-job training an NCHD receives from his consultant rather than conferences abroad, laptops and PDAs;).0 -
Jane, I hear ya but my very point is that NCHDs need to act as a group. It may require someone to get things going. I dont know how much you know about 2000 but what happened there showed how, if a few people plant the seeds of rebellion in other's minds, things can take off pretty rapidly.
Anyone know of any NCHDs from 2000 whose careers have been adversely affected by their actions in that dispute? Didnt think so.0 -
Sadly, the 2000 "uprising" was before my time, was only in college then, but yeah, we need something like that again. Problem is, most NCHDs have been so brainwashed re: striking that they are much more reluctant now than they were before to do this, and it is one of the only bargaining cards they have.
In NZ one of the consultants responsible for our training gave us a paper to read on the ethics of striking-it basically said that doctors were morally and ethically obliged to strike if there was no other way around it and the aim of the strike was to prevent conditions from deteriorating so much that doctors either left the country or the profession.
Because no doctors in the country kills people, whereas controlled strikes just delay things and cause hassle. I really like that guy, and he had a very good point.0 -
I do think though that for sure something we should all begin doing is organising ourselves within our own hospitals, and implementing change where it will do some good.
For instance, I know of one peripheral hospital where the few NCHDs there, who were a tight knit bunch, got together and sent out a memo to all the wards that they were no longer giving first doses as there was no evidence for this practice and they were run off their feet. Then they began refusing to give them, individually, while on call or at work. They garnered support from some unlikely corners, including one consultant as old as the hills and quite a few of the younger nurses. And now there is no "first dose" in that hospital. (Mind you, the HSE will probably close all the small hospitals soon anyway, but you get the picture).0 -
Sadly, the 2000 "uprising" was before my time, was only in college then, but yeah, we need something like that again. Problem is, most NCHDs have been so brainwashed re: striking that they are much more reluctant now than they were before to do this, and it is one of the only bargaining cards they have.
Believe me Jane, the attitude to striking (and not rocking the boat in general) was far more conservative in 2000 amongst medics than it is now. In 2000, the only precedent we had was the 'strike' in the 1970s and a day didnt go by without someone trotting out the urban legends (perhaps true?) about a handful of then NCHDs who were railroaded out of the profession following their involvment in the 1970s strike. Now, you guys have the 2000 strike as a precedent; noone was railroaded out of the profession on foot of it (except me, but that was by choice...;)); i'd challenge you to name even one NCHD who was seen to be centrally involved in the agitation back then?; it was very succesful; it showed that the (forerunner of the) HSE will compromise when the pressure is on; most consultants with 1-10 years expereince now were 'involved' (at least to the extent that they rowed in behind those of us who took the lead) and should understand your predicament.
So, Jane, its actually easier to strike now than it was in 2000, much much easier. There is only one factor that makes it worse and that is the economic climate; but that is why you need to control the agenda. Use the massive NCHD overtime bill we read about in the Sindo every now and then; turn it to your advantage; tell the public why you want to get rid of it AND improve patient care AND get rid of 80+ hr/weeks.0 -
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Pastafarian wrote: »Most consultants are against EWTD and want their staff working entire weekends in the name of 'continuity of care'. Thus remaining in denial that handover is an inevitability and instead of learning to do handover better, sticking their heads in the sand.
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Sorry but that is not true at all , many of todays consultants went on strike in 2000 not to make money but to reduce our hours - most consultants support the EWTD.0 -
Sorry but that is not true at all , many of todays consultants went on strike in 2000 not to make money but to reduce our hours - most consultants support the EWTD.
Hey Traumadoc.
You put me in a difficult position here - there is a limit to what I can say.
Suffice it to say - most does not equal all. Quite what figure are for or against is up for debate - but I do know for a fact that not all are in favour of the EWTD.0 -
Yes that is true especially in surgical specialities who believe you learn by working thousands of hours to gain experience ( learn by mistakes etc) - but many other countries - Australia and newzealand can train surgeons without having to work more than 50 hours per week.0
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Yes that is true especially in surgical specialities who believe you learn by working thousands of hours to gain experience ( learn by mistakes etc) - but many other countries - Australia and newzealand can train surgeons without having to work more than 50 hours per week.
Most would argue however that an Irish trained surgeon is much more experienced and independent than those in either the States where the training in years is much shorter, the UK where they have dropped the operating hours of a trainee to a third of what it was (with a corresponding massive increase in the suspension rates for new surgeons in the first 2 years of practice). In Australia, similar to the states, newly qualified surgeons are much more supervised in their first few years due to lack of experience.0 -
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Most would argue however that an Irish trained surgeon is much more experienced and independent than those in either the States where the training in years is much shorter, the UK where they have dropped the operating hours of a trainee to a third of what it was (with a corresponding massive increase in the suspension rates for new surgeons in the first 2 years of practice). In Australia, similar to the states, newly qualified surgeons are much more supervised in their first few years due to lack of experience.
in the states after your residency(board certification), you are free to work private practice, unsupervised, as you are a board certified physician/surgeon but some do chose to do a fellowship(extra 1-3 years depending on speciality), alot of people dont do fellowships in specialities like say, anesthesia(4 years), general surgery(5 years), dermatology(4 years), A&E (3 years) family practice (3 years), psych (3-4 years) and so on, they just go straight into a private partnership/group practice.
most fellowships are probably done in either internal medicine or pediatrics, but even with those you can work as a hospitalist unsupervised without a fellowship, but a hospitalist is not a consultant as someone mentioned earlier, even though they are the "attending physician".0
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