Rapid Responses to:

EDITORIALS: Michael Goldacre Planning the United Kingdom's medical workforce BMJ 1998; 316: 1846-1847 [Full text]

Rapid Responses: Submit a response to this article

Rapid Responses published:

Increase in Med School intake

Adarsh Babber   (22 June 1998)

Planning the United Kingdom's medical work force

A Pickersgill   (21 August 1998)

Increase in Med School intake 22 June 1998
Adarsh Babber, student J L School Send response to journal: Re: Increase in Med School intake	After reading this particular article it has become very noticeable that the UK requires more junior doctors to reduce the workload of the already overworked doctors. However, it should also be considered that with releasing pressure of the modern junior doctors by increasing Medical school intake, there will also be a better chance for more potential students gaining entry into Medical school. This applys especially for those that have a true passion for the study of Medicine, with the required academic ability, but which may not be greater than the majority of the other applicants. This is my view because I am one such student who applied but was unsuccessful in gaining entry to any of my choice of medical schools, although I have passion and am commited to a career in Medicine. My GCSE grades are of a standard that allow me to apply to medicine and I also have the relevant experience required . I have also seen a number of students either apply because they have the necessary very high grades although do not know about the study of medicine or because of family pressures. These applicants seem to be successful in gaining places at Medical school and consequently successful in gaining a very different and hard future than they normally imagined for themselves. This may be a reason for the fewer doctors today. I do accept the fact that after interview the selectors are able to weed out those applicants that are not suitable, but the increase in places would mean a more diverse selection for interview which would be a great opportunity for applicants like me to show our love for the subject. Therefore I am all for the inrease in Medical school intake and hope that the more interested students, who ultimately form the best doctors, are more readily given places.
Planning the United Kingdom's medical work force 21 August 1998
A Pickersgill Send response to journal: Re: Planning the United Kingdom's medical work force	Medical workforce planning has recently been the subject of headline news both in the medical and lay press1-3. The third Report of the Medical Workforce Standing Advisory Committee4 recommended increasing medical school intake by approximately 1000 per year. Frank Dobson confirmed plans to phase this increase to help create the "extra" 7000 doctors necessary to staff the NHS. Unfortunately we are not party to the long term plans of the Department but hope that these "extra" doctors are not soley juniors, otherwise it will only create further problems. There is no contention that more doctors are needed. This need is generated by multifactorial reasons including the reductions in junior doctors hours, Calman reforms, more women in medicine and increasing patient expectations as described in detail by Goldacre1. But what Goldacre fails to highlight is that we can only increase the number of juniors if we increase the number of job opportunities at the other end (General Practitioners or Consultants). At present medical workforce planning in this country fails. In my speciality of Obstetrics and Gynaecology we find ourselves in the position of having fully trained doctors (on the specialist register) unable to find Consultant appointments. This situation has arisen for two reasons, the Calman reforms and inaccurate workforce planning. Currently we have in excess of 150 such individuals, some facing redundancy in the near future when their 18 month post CCST extension expires. On average (in our speciality) there have been 70 to 80 consultant opportunities annually over the last few years. Roughly half are new posts (created with task force monies) and half are retirements or deaths. In reality consultant expansion rates are now slowing (3.1% in 1997, predicted to be >5%) and output is increasing. If further home-produced junior doctors enter the equation the situation will worsen. Even more than the 20% of doctors who currently leave in their first ten years5 will be lost, at vast expense to the tax payer and to the profession. So in times of increasing clinical throughput and patient expectations, with developing demands for clinical governance and a consultant based service, surely Mr Dobson and colleagues must first look to increasing the numbers of Consultants and retaining more doctors in training before increasing the number of medical students that will soon become disillusioned with their prospects. REFERENCES: 1. Goldacre M. Planning the United Kingdom's medical workforce. BMJ 1998; 316: 1846-7. 2. Klein R. A generous birthday present to the NHS. BMJ 1998; 316: 224-225. 3. Daily Mail (Front Page). Why can't we train enough doctors? Friday July 24th, 1998. 4. Medical Workforce Standing Advisory Committee. Planning the medical workforce.Third Report. London: Department of Health, 1997. 5. Lambert TW, Goldacre MJ, Parkhouse J, Edwards C. Career destinations in 1994 of United Kingdom medical graduates of 1983: results of a questionnaire survey. BMJ 1996; 312: 893-7. A Pickersgill, Lecturer in Obstetrics and Gynaecology. Chairman RCOG Trainees Committee