Mandate graduate doctors do 5 years in Ireland post qualification?

medicine12345

towelly wrote: »

The last point (re positivity) was a joke, but on a serious note, when somebody is that negative about their job it's time to move on.

thats what they're doing... to australia, america etc, hence what the thread is about

towelly

ProfessorPlum wrote: »

Maybe. But each of those professionals can choose to work wherever they please. Nobody is suggesting they are tied to working a job they don't want to be in. Why should doctors?

What is your point re the issue of the thread???

Doctors can't choose the area in which they like to work, or whether it's a public or private practice?

I made a few relevant points earlier. Since they were too hard for some people to listen to or understand, now I'm just here to call "Bull****!" à la Karl Pilkington.

ProfessorPlum

towelly wrote: »

Doctors can't choose the area in which they like to work, or whether it's a public or private practice?

I made a few relevant points earlier. Since they were too hard for some people to listen to or understand, now I'm just here to call "Bull****!" à la Karl Pilkington.

Any answer forthcoming to the question you were asked?

UCDVet

Wouldn't this just make potential doctors more likely to
1.) Choose another field
2.) Get educated somewhere else


I'm not sure either of those would really help Ireland. If the goal is to get more doctors, having people leave for med school elsewhere certainly won't increase the odds of them returning.

chumbawumba369

towelly wrote: »

I didn't say medicine isn't a tough course, I accept that some doctors work long hours, I just don't buy into the bull**** on here that it's the most difficult course and job ever and nothing else compares! You really should read posts properly, instead of getting worked up over them when you don't.

The last point (re positivity) was a joke, but on a serious note, when somebody is that negative about their job it's time to move on. Some people crack easier than others, there are certain types of environments where some people just aren't suited.

I have to say, I have fortunately had very limited dealings with doctors and medical professionals in a professional capacity, mostly in a social capacity. None of them, fortunately for them and those around them, seem to have the attitude that some of ye on boards.ie have.

Ah come on now, you've made some poor points and now you're saying the problem is with reading posts and attitude. And no-one has said that medicine is the toughest course or being a doctor is the toughest job either. I said myself earlier I always thought veterinary is a good bit tougher. The hours are rotten which I keep saying and people will keep leaving because they're not going to want to kill themselves working here when there's far better career progression and work life balance else where.

You're being a wee bit catty with that last paragraph too.

towelly

chumbawumba369 wrote: »

Ah come on now, you've made some poor points and now you're saying the problem is with reading posts and attitude. And no-one has said that medicine is the toughest course or being a doctor is the toughest job either. I said myself earlier I always thought veterinary is a good bit tougher. The hours are rotten which I keep saying and people will keep leaving because they're not going to want to kill themselves working here when there's far better career progression and work life balance else where.

You're being a wee bit catty with that last paragraph too.

Come off the stage

UCDVet

towelly wrote: »

If a project manager gets something wrong, buildings can collapse, fires can destroy everything in their path, people can lose their life or become seriously ill. If a project manager makes a mistake, he and his colleagues may not get paid at the end of the month.

We must be in very different industries!

Our team's project manager got sick, took two weeks off. We had an 85% drop in both power point presentations and meetings - but other than that, everything went swimmingly.

take everything

towelly wrote: »

Sounds incredibly tough alright

Have you ever done a shift lasting 56 hours. Or maybe 72 hrs.
If you haven't, you don't know what you're talking about.

take everything

towelly wrote: »

Doctors can't choose the area in which they like to work, or whether it's a public or private practice?
.

No, NCHDs in Ireland don't have a say in this.
Are you confusing NCHDs with consultants; we're all talking about NCHDs here.

Also, the hours are mandatory (this is the important distinction).

Oh wait... unless they leave the country for better training and conditions, i suppose.

ProfessorPlum

take everything wrote: »

Have you ever done a shift lasting 56 hours. Or maybe 72 hrs.
If you haven't, you don't know what you're talking about.

I don't think we need an answer to this question to realise that he doesn't know what he's talking about.

take everything

chumbawumba369 wrote: »

Ah come on now, you've made some poor points and now you're saying the problem is with reading posts and attitude. And no-one has said that medicine is the toughest course or being a doctor is the toughest job either. I said myself earlier I always thought veterinary is a good bit tougher. The hours are rotten which I keep saying and people will keep leaving because they're not going to want to kill themselves working here when there's far better career progression and work life balance else where.

You're being a wee bit catty with that last paragraph too.

But you see, NCHDs only get the right to complain about this if medicine is the hardest course/career EVAR.
Don't you understand?

steddyeddy

chumbawumba369 wrote: »

I think doctors get singled out by the media for lots of reasons, we're seen as elitist and minted and no-one likes paying a GP 50 quid. But there's certainly a lot of ridiculous comments and misconceptions about doctors too. I've always thought 'Junior doctor' for example is an insulting title for an SpR with 8 years experience and people with no clinical experience have no problem making absolutely ridiculous comments which has happened in this thread. Christ, you yourself criticised using three antibiotics and what was that based on? Embarrassing.

Well it doesn't help the elitist image when people talk about the hardest degree ect. I have teaching responsibilities and I teach medical students biochemistry and it's something they struggle with. The course has been repeatedly dumbed down to a level far more basic than a pure biochemistry degree. So it's a bit rich to make out it's the most complicated or hardest degree. I agree there is a lot in it but I don't think the principles are particularly difficult to grasp.

Embarrassing? It's not embarrassing that antibiotic resistance has created Methicillin-resistant Staphylococcus aureus and other advanced stains. Three antibiotics is absolutely crazy and we need to be more advanced in our thinking.

I think veterinary is a harder degree than medicine but I can't see many other degrees being equally hard. 7am surgery starts on placement, getting regularly grilled and embarrassed by consultants, written exams and OSCEs with a huge knowledge requirement; if you get a 1st or an A in a medicine degree you deserve it, in my class 2% of people did. That's 2% of people with 580 plus points in their leaving so they're mostly going to be very hard workers. There's a reason it's a 5-6 year degree, you can't fit it all into 3 or 4 years like some business or science degrees. The final few years are a complete slog

Again try four years of biochemistry before you comment. I agree completely that the first thing that needs to change is the working hours. They are completely unacceptable. It's basically slave labour IMHO and it is ridiculous that we are in breach of EU laws. Saying medicine is tougher than all course (quantum physics or biophysics) doesn't help!

And I've noticed you have a problem referring to doctors as 'doctor', I've never used the title outside of work but don't you feel that we earn the title? Or should it be for those with pHds who remain in the education field.

Clinicians is a term scientists use to describe medical doctors. The term doctor is a title. I use the term here because I use it in my work a lot. If we're collaborating with a consultant we refer to him as a clinician as distinct from scientist. That's what annoyed me really. I hear arrogance regarding medicine from consultants everytime we collaborate. My boss was involved in the synthesis of inhibitors specific for proteases involved in malaria and the consultant on the paper was talking about how he was the real brains behind it.

Iwasfrozen

towelly wrote: »

That's not a possibility, the only people that are worse than the fools that suggest it are the fools that take them seriously!

So what do you propose?

towelly

take everything wrote: »

Have you ever done a shift lasting 56 hours. Or maybe 72 hrs.
If you haven't, you don't know what you're talking about.

ProfessorPlum wrote: »

I don't think we need an answer to this question to realise that he doesn't know what he's talking about.

I have done so, and without taking any break. Maybe I missed my calling as a doctor?

chumbawumba369

steddyeddy wrote: »

Well it doesn't help the elitist image when people talk about the hardest degree ect. I have teaching responsibilities and I teach medical students biochemistry and it's something they struggle with. The course has been repeatedly dumbed down to a level far more basic than a pure biochemistry degree. So it's a bit rich to make out it's the most complicated or hardest degree. I agree there is a lot in it but I don't think the principles are particularly difficult to grasp.

Embarrassing? It's not embarrassing that antibiotic resistance has created Methicillin-resistant Staphylococcus aureus and other advanced stains. Three antibiotics is absolutely crazy and we need to be more advanced in our thinking.

Again try four years of biochemistry before you comment. I agree completely that the first thing that needs to change is the working hours. They are completely unacceptable. It's basically slave labour IMHO and it is ridiculous that we are in breach of EU laws. Saying medicine is tougher than all course (quantum physics or biophysics) doesn't help!

In fairness biochem is a tiny part of the medicine course and we didn't cover it after my 2nd year in college and I haven't really though of it a huge amount since. I didn't particularly like it myself and I appreciate there's probably an aptitude needed for it. We cover the basics in a short time because that's all we need to know. It's the same with a lot of other stuff we do in the earlier years, we covered physics when learning about ECGs.

Believe me I know about MRSA but the point is if you don't know the cause of an infection you have to cover all the likely causes and to do that you can't wait a day for cultures to come back from the lab, you have to do it straight away. Ideally you get input from micro and start them on broad spec to cover Gpos and neg or whatever it's likely to be.

The embarrassing thing wasn't fair for me to say really. What I meant was that for someone doing a pHD whose all about research and having an evidence base it seemed a bit strange for you to say that three antibiotics was ridiculous. The reality in practice is that sometimes more than one antibiotic is needed and the evidence supports that. That's not crazy, that's treating the patient as promptly as possible based on the likely cause. If you wait fro the culture and sensitivities to come back you're doing you're bit for Abx resistance but not the patient.

Everyone thinks their own course is difficult, you think biochem is tough because you did it, I think medicine is tough because I did it. For medicine it's more juggling the placements lectures and study with patient histories and exams that makes it tough. There's no real tough concepts like in a maths/physics subject just a big workload and keeping your cool when consultants try and rattle you in OSCEs! I always found it much easier to do well in the written exams opposed to the practicals because you've more time to think. To be fair I never said it was the stuff to be learned that made med difficult. I do stand by what I think about vet being the toughest undergrad though, it's just brutal.

steddyeddy wrote: »

Clinicians is a term scientists use to describe medical doctors. The term doctor is a title. I use the term here because I use it in my work a lot. If we're collaborating with a consultant we refer to him as a clinician as distinct from scientist. That's what annoyed me really. I hear arrogance regarding medicine from consultants everytime we collaborate. My boss was involved in the synthesis of inhibitors specific for proteases involved in malaria and the consultant on the paper was talking about how he was the real brains behind it.

That's fair enough, I have friends who've done pHDs and never envied the workload. I can well imagine some consultants being incredibly arrogant, you're lucky you don't have to see it everyday. They can think they're a breed apart sometimes. They annoy everyone.

chumbawumba369

towelly wrote: »

I have done so, and without taking any break. Maybe I missed my calling as a doctor?

You didn't miss your calling as a fantasist anyway.

Ah no, maybe you've stopped talking rubbish and are telling the truth. I haven't heard of many jobs where you'd have to do hours in work like that though. To be honest if you're willing to those kind of hours the whole time and have a medicine degree you'd be HR's wet dream.

take everything

steddyeddy wrote: »

Well it doesn't help the elitist image when people talk about the hardest degree ect. I have teaching responsibilities and I teach medical students biochemistry and it's something they struggle with. The course has been repeatedly dumbed down to a level far more basic than a pure biochemistry degree. So it's a bit rich to make out it's the most complicated or hardest degree. I agree there is a lot in it but I don't think the principles are particularly difficult to grasp.
Saying medicine is tougher than all course (quantum physics or biophysics) doesn't help!
.

I don't think many doctors think that the material is difficult to grasp. Physics and maths for example are more intellectually taxing.
It's the amount of material that is demanding.
The problem-solving bit (the hypothetico-deductive reasoning) that uses the biomedical science is what is intellectually taxing towards the end of med school and during training. Not to mention the myriad emotional/social aspects of treating patients/hospital politics etc.

When you take all this into account and the fact that you are dealing with patients' lives, then yeah it's about as demanding as anything out there.

That's before you even talk about 36 hr shifts and generally being abused and shat on by all and sundry (just look at how poorly represented NCHDs are by the IMO and the likes of its CEO retiring on lotto money; contrast that with the nursing union for example- straying off the topic but you get the idea).

steddyeddy

take everything wrote: »

I don't think many doctors think that the material is difficult to grasp. Physics and maths for example are more intellectually taxing.
It's the amount of material that is demanding.
The problem-solving bit (the hypothetico-deductive reasoning) that uses the biomedical science is what is intellectually taxing towards the end of med school and during training. Not to memtion the myriad emotional/social aspects of treating patients/hospital politics etc.

When you take all this into account and the fact that you are dealing with patients' lives, then yeah it's about as demanding as anything out there.

That's before you even talk about 36 hr shifts and generally being abused and shat on by all and sundry (just look at how poorly represented NCHDs are by the IMO and the likes of its CEO retiring on lotto money; contrast that with the nursing union for example- straying off the topic but you get the idea).

That's one thing that I find interesting about the situation. The IMO is a pathetic union. Baggage handles at Dublin airport are better represented than doctors.

medicine12345

steddyeddy wrote: »

Well it doesn't help the elitist image when people talk about the hardest degree ect. I have teaching responsibilities and I teach medical students biochemistry and it's something they struggle with. The course has been repeatedly dumbed down to a level far more basic than a pure biochemistry degree. So it's a bit rich to make out it's the most complicated or hardest degree. I agree there is a lot in it but I don't think the principles are particularly difficult to grasp.

Embarrassing? It's not embarrassing that antibiotic resistance has created Methicillin-resistant Staphylococcus aureus and other advanced stains. Three antibiotics is absolutely crazy and we need to be more advanced in our thinking.

Obviously the biochemistry course a medical student does is alot more basic than doing a pure biochemistry degree!! It is only a small part of what we do in first and second year (whilst also studying anatomy, physiology, pharmacology, pathology, microbiology, neuroscience etc never mind all the clinical skills - cardiology, gastroenterology, neurology, etc
What is your logic in implying that medical students find it more difficult to grasp complex subjects than science students or any other students?? bizarre unless you think that intelligence is inversely proportional to leaving cert points??

On the 3 antibiotics. They are rarely needed but they are clinically needed in certain situations for example a neonate with suspected meningitis or someone with sepis. If you want to cover for listeria, e.coli, n.meningitis etc you mah give ampicillin, a 3rd gen cephalosporin etc. Try telling the parents of a dead child 'sorry we didn't cover for everything as we didnt want to risk adding to antibiotic resistance'. Once the cultures come back and you know what you're dealing with you can cut the antibiotics back to one. There are times when every second counts and these are real individual people who you have to treat to the best of your capacity

steddyeddy

medicine12345 wrote: »

Obviously the biochemistry course a medical student does is alot more basic than doing a pure biochemistry degree!! It is only a small part of what we do in first and second year (whilst also studying anatomy, physiology, pharmacology, pathology, microbiology, neuroscience etc never mind all the clinical skills - cardiology, gastroenterology, neurology, etc
What is your logic in implying that medical students find it more difficult to grasp complex subjects than science students or any other students?? bizarre unless you think that intelligence is inversely proportional to leaving cert points??

I'm not saying medical students can't grasp complex points at all. I'm making the point that there are some very hard courses difficult in different ways to medicine.

No I don't think there's much of a link between intelligence and the leaving cert. Looking at it scientifically there's too many variables for it to be an accurate test. The school you had for instance largely determines points. It's a glorified memory test IMHO.

On the 3 antibiotics. They are rarely needed but they are clinically needed in certain situations for example a neonate with suspected meningitis or someone with sepis. If you want to cover for listeria, e.coli, n.meningitis etc you mah give ampicillin, a 3rd gen cephalosporin etc. Try telling the parents of a dead child 'sorry we didn't cover for everything as we didnt want to risk adding to antibiotic resistance'. Once the cultures come back and you know what you're dealing with you can cut the antibiotics back to one. There are times when every second counts and these are real individual people who you have to treat to the best of your capacity

But in fairness there will come a time when a clinical microbiologist will have to veto prescription of antibiotics even if there is an increased risk of ill health. The needs of the many outweigh the needs of the few as Spock would say.

medicine12345

steddyeddy wrote: »

But in fairness there will come a time when a clinical microbiologist will have to veto prescription of antibiotics even if there is an increased risk of ill health. The needs of the many outweigh the needs of the few as Spock would say.

clinical microbiologist as in consultant microbiologist? No realistically that won't happen for most antibiotics - ie the amoxicillin etc given out on a daily basis by GPs etc. For some antibiotics eg vancomycin, meropenam etc i believe you do need consultant microbiologist approval or at least its reviewed by them. And in theory that may be well and good about the needs of many but tell that to the sick patient lying in front of you...

Nonoperational

I personally think that academically medicine is far from the hardest degree out there. It's taxing in other ways and the practical exams and placements can be very stressful.

On as aside, sometimes 3 antibiotics can be good practice and actually reduces the likelihood of the selection of resistant organisms. Better to treat properly than under treat.

unkel

36 hour shift, 100 hour working week?

I'm surprised nobody in this thread has yet pointed out that includes the time the person was on call / asleep.

Icemancometh

unkel wrote: »

36 hour shift, 100 hour working week?

I'm surprised nobody in this thread has yet pointed out that includes the time the person was on call / asleep.

In my last hospital job I had to do 24 hour shifts, ie being on call. I was never actually called during most of these shifts, as I would spend the entire time in the ED admitting patients. I would estimate that about 80% of these I would get about a half an hour's sleep, or a break if you will, before the morning ward round. Of course, there was the 20% of the time where I might get 2-3 hours sleep.

steddyeddy

Is the IMO actually doing anything about these breaches in EU law?

Icemancometh

steddyeddy wrote: »

Is the IMO actually doing anything about these breaches in EU law?

Just enough to keep people paying their union dues, which seems to be their main interest.

Red Alert

The IMO sound like TUI to be honest - a union thoroughly uninterested in the problems of younger employees.

One way around mandating this is to go back to having college fees for all courses, with a resultant reduction in taxation.

Celticfire

steddyeddy wrote: »

But in fairness there will come a time when a clinical microbiologist will have to veto prescription of antibiotics even if there is an increased risk of ill health. The needs of the many outweigh the needs of the few as Spock would say.

With this veto will the microbiologist then take over and accept responsibility for the patient and their outcome?

unkel wrote: »

36 hour shift, 100 hour working week?

I'm surprised nobody in this thread has yet pointed out that includes the time the person was on call / asleep.

It must be a pleasure to go to work and find chocolates on the pillow of your Egyptian cotton clad bed as you settle in for a glorious 9 hour uninterrupted sleep with fresh croissants and coffee brought to you an hour before quitting time...

towelly wrote: »

I have done so, and without taking any break. Maybe I missed my calling as a doctor?

56 or 72 hours without a break??? Considering your very short answer to the list that I asked for earlier I'd say you're a bit under-generous with the truth.

zl1whqvjs75cdy

Do the medics amoung us feel that there is apathy at the top for the plight of junior doctors? It seems to me that there is an attitude amoung established clinicians that they had to work the long hours and now it's the turn of the new generation?

Taco Chips

donkeyoaty0099 wrote: »

Do the medics amoung us feel that there is apathy at the top for the plight of junior doctors? It seems to me that there is an attitude amoung established clinicians that they had to work the long hours and now it's the turn of the new generation?

Absolutely. I was at a careers talk recently with a number of consultants as speakers. A couple of them complained out loud to the crowd (of medical students) how can people expect the training to be as good with EWTD in place. No thought of how little actual training/education is going on about 28+ hours into an average NCHDs shift.