No time to train the surgeons: Learning from the New Zealand experience
BMJ 2004; 328 doi: https://doi.org/10.1136/bmj.328.7448.1134-a (Published 06 May 2004) Cite this as: BMJ 2004;328:1134
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I read with interest the debate on surgical training and working time
directive. I was surprised to read the last comment by Dr Lauren Ovens
about overseas trainees. I would like to make the following comments:
1. There are thousands of overseas trainees working in the Uk
especially in places not very attractive to British qualified trainees.
If they go these place will simply close.
2. To suggest they should review their future in the Uk is
counterproductive. It will not help the NHS if they decided to leave
because of the quality of training. If Britain is seen as providing poor
training this will be a great shame for the profession and Royal Colleges.
We should develop ways of maximising training for local and overseas
candidates alike for everybody's benefit.
3. Many overseas doctors have made outstanding careers in the UK.
Let us not forget Sir Magdy Yacoub, who took cardiac surgery into the 21st
century. This is only one example. I do not expect the road is paved for
overseas candidates; rather they face fierce competition. Some have
outstanding qualities and a lot to offer the healthsevice in the UK.
4. The expansion of the EU will bring more overseas doctors to the
Uk, and help our shortage, let us not put them off. As the slow long
awaited expansion of the consultant grade takes place, we desperately need
overseas doctors, who seek to gain experience here for sometime and go
back to benefit the health services in their homeland.
5. Finally, does Dr Ovens raelly has no competing interests? or is
he/she not actually competing with these overseas doctors for junior
posts?
R Daoud
Consultant Surgeon
RCS of England surgical tutor
Frimley Park Hospital,
Portsmouth Rd,
Camberley,
Surrey
GU16 7UJ
Competing interests:
None declared
Competing interests: No competing interests
Postgraduate Medical Education Training Board
EDITOR-No time to train the surgeons is a special case of a specific
difficulty inherent in the new PGMTB set-up. Careful inspection of the
arrangements for the new PGMTB shows that it is almost entirely composed
of members who represent specialties in which the acquisition of practical
skills (the logbook model) is not the main feature of training. Not all
of these specialties are surgical - cardiology, gastroenterology,
radiology, and others such as A&E have a major component where
practical skills are essential to good clinical practice. The
combination of this inferior and shoddy set-up with the downgraded
undergraduate medical school syllabus should ensure that British graduates
will not only be unable to function even at the most basic level but also
will not have qualifications recognised in other countries around the
world. The time has come to recognise that there will be a different
medical career structure in the future where career progression continues
after initial postgraduate training. The current proposals for a CST
represent a level of training equivalent to the end of General
Professional Training under the current model - that is the end of SHO
level work and the eligibility for appointment to a registrar job.
Obviously such a level of certification will in no way create
"specialists" fit to be appointed to autonomous practice but rather
doctors who are capable of determining their own competence and asking for
expert help where relevant much as current GP training is organised now.
Competing interests:
I am a fully trained registered medical practitioner.
Competing interests: No competing interests