u/chairstool100

We can’t have it both ways .

We have Drs say “well the PA didn’t do MRCP”……ok so what? What if they DID do MRCP, are they now equivalent? No , of course not .

“An ANP hasn’t done the SCE in their specialty “…..so what? Let’s say we allowed the Gastro ANP to do the Gastro SCE exam and they passed , would we say they’re equivalent? Clearly not .

What about doctors who work on a medical ward who haven’t yet done MRCP ? Are they more equivalent to the PA because neither of them have the qualification?

IMO, we should stop reducing our existence as a profession into a sum of parts . We are more than a sum of our parts . The nature of our job is different even if the ANP clerking the next pt in hypothetically did MRCP. An anaesthetic doctor inducing a sick patient is different from the ACCP observing them even if that doctor doesn’t have any part of the FRCA completed .

A day 1 FY1 doctor is different from a day 1 PA . There is a fundamental difference in how our profession approaches a certain clinical situation and expectations of leadership that goes with it .

I for one think my medical degree was extremely useful and forms a key PART of what differentiates me from other professions even if 80% of what I use day to day comes from the things I treat in my specialty /the mental frameworks the FRCA gave me .

I feel bad about disrupting the interaction from the offset if it isn’t actually affecting their care , but I’m also internally raging at how people can talk to me with headphones in.

Edit : To those asking why this is even a question - I’m an anaesthetist . I don’t want to make the pt think I’m angry at them prior to me sending them to sleep when they feel very vulnerable . If they can hear me otherwise during my assessment , then I just wondered if it’s easier to just let it go .

It’s easier than taking a blood sugar …..but when the pts RR is actually 28 but documented as 16, I don’t see this as any different to me seeing an ECG, acknowledging STE yet documenting it as normal .

I don’t recall anyone dying from incorrect RR documentation but where do we draw the line ? Can we write an incorrect BP ?

Im in HST but from what I’ve observed , those doing CESR have to provide much more evidence for identical competencies .

I’m just asking neutrally here !

Is it because the evidence can be a bit ….weak ? As it can be from abroad ? I thought the GMC reviews it anyway? Or is it because they’ve not gone through the natural selection hurdle of applying for training?

I’ve met colleagues who are on a CESR programme and their rotas are identical to mine and they’re doing the specialty exams . They’re having to achieve and demonstrate the same things .

This is often the reason I’ve read online …”XXX has to use the MSRA because there aren’t enough consultants/GPs who are willing to volunteer to interview more candidates…”
“XXX specialty can’t do face-to-face interviews because it would be too difficult to organise them, not enough volunteers etc “
“If we did face to face interviews , we would have to reduce the number of candidates being interviewed”

To me, this is like saying pts can’t be discharged fast enough because there aren’t enough printers to print the D/C letter . That shouldn’t be the end of the discussion.

How did we manage before Covid ? Or didn’t we manage ?

I’m in HST and I had face to face interviews.

Additionally , I totally understand consultants not wanting to spend half a day/a day interviewing candidates for free - SURELY a good use of college funds ,(which to my understanding always runs in a profit anyway) would be to pay interviewers so that its speciality can offer a fair(er) interview process ?

Is this true ? I’m only specifically referring to them saying they treat “ALL” gynae and chronic health problems .

I then asked them if therefore the practice nurse treats pts with CKD with HOCM on LTOT or the pt with hypogonadism and menorrhagia . I was blocked for being a bit facetious but more importantly, for asking if the practice nurse not only treats the same problems as the GP, but even treats problems that not even the GP treats .

Is this true ?

Nurses can absolutely speak out against scope creep by NAs and APs but a Doctor is seen as causing trouble if they challenge these type of assertions .

I understand that we are currently at 2020 level in terms of pay restoration?.
Where would 6.6% put us at?

I’ve read clinical entries by them over the years which arguably shows they know their area of healthcare in their dept quite well , but there are things which show lack of thought or that deeper understanding we would expect from Drs.
Giving fluid /Abx when it’s not indicated or coming to a diagnosis or missing something they “didn’t know they didn’t know “ etc are things I’ve come across from them and fellow doctors .

I’ve also made these mistakes but it’s fine if my SHO/Reg/Cons over the years teaches /corrects me . Sometimes they’ve missed important bits of the PMHx. If a CT1 misses it then i can just teach them…..but if one of these other roles makes the same error , i would just keep quiet .

Eventhough I’m ST6 , I would feel totally incapable of telling an ACCP on ICU that what they’ve said doesn’t quite make sense and I definitely wouldn’t suggest they pick a topic which I can teach them about ….despite me doing this for the Drs who are junior to me .

I know where Drs fall in the chain of hierarchy whereas I don’t know where all these roles sit.
As a F1 I knew DKA extremely well (and still do!) - it’s pathophysiology , treatment etc. On ICU, I hear some ACCPs just going by the protocol and sometimes think if I had been the FY2 on ICU , I would have provided some impromptu quizzing to my F1 ….they are junior to me and would likely benefit from it if they were receptive to it . However , would a FY2 /CT1 /STx offer this to one of these non-Dr roles ?

It would invariably come across as snooty EVENTHOUGH it shouldn’t . I would feel as if they think I’m being arrogant because they view themselves as AT LEAST equivalent to a fully qualified doctor who has been working for a few years (SHO) .

I keep reading anti-strike articles which say that the BMA “claim” that our pay has been cut in real terms by XYZ etc. I’ve always gone on strike since IA started but I’m also being objective too .

It’s one thing people being against strikes due to moral reasons but it’s another thing entirely to be against them because the reason for them isn’t believed to be true….

I appreciate there’s a difference between which inflation measure you use …but even if we use the one which works against us , where are we at now in terms of pay restoration? Which year ?

Does anyone have simple data which plots hourly pay for the same grade of doctor across 15 years vs inflation?