Friday, 1 October 2010

GP Trainers.

In the United Kingdom most people when they are “ill” are seen by a GP. In the US we believe this is known as family medicine. In the long distant past you could become a GP after you had done a year’s worth of hospital medicine and then go out “into Practice”.

The UK Doctor in the House series of films based on a series of books by Richard Gordon illustrates this state of affairs in earlier times but in order to watch these antique films (50+ years old) you will have to find them. Sometimes they are aired on UK TV.

Watch them as a doctor and you will see how little has change watch them as a non medic and they are quite funny at times.

In 1981 we believe that the UK introduced VTS (Vocational Training Schemes) for General Practice. A seemingly good idea to ensure that any future GP would be trained to a basic minimal standard. In 2007 they also introduced a compulsory exam the MRCGP.

We have commented before re useless unnecessary electronic crap for medical training but this week we have been listening to a group of highly intelligent, well motivated doctors in training wanting to be GPs and also those who have recently qualified as GPs who were all saying the same thing while chatting in the breaks at a meeting.

All are enthusiastic, far better qualified in terms of letters after their names than are we but perhaps less qualified in terms of hours in the air.

They are complaining, quite rightly, about an increasing amount of totally unnecessary information that needs, or needed, to be uploaded to their e-portfolio at incredibly short notice. This is at the behest of their trainers and other educational supervisers. Here is a link to what an e-portfolio is and we love the description or it as “glue” which these young doctors were complained that they were increasingly stuck in.

For those that are not familiar with e-portfolios this is basically a useless piece of NHS software insisted upon by a generation of GPs who never understood computers but who thought they were great. They thought that if you could book a hospital appointment for a patient online then you could justify a half hour appointment time and so avoid any real work by being a booking clerk. Unfortunately they are in charge and so busy jerking off to matters electronic that they miss the basics of education.

They missed the space age, log table, slide rule and electronic calculator and no doubt feel that the film the Wicker Man is progress as it shows community involvement in holistic care. This is the Royal College of General Practitioners whose journal is so full of real science that you would believe the world is flat after reading it.

Now to become a GP trainer, in order to train a GP registrar, a future GP, you have to undergo a series of courses and approval visits as well as have the MRCGP exam. Being a human being is not an essential requirement as the training ensures that trainers are Party approved quislings. No bad thing but what is the net result of these?

Well from our own experiences and our conversations with new qualified GPs and those still in training and despite all of the “supervision” from the RCGP, locally we have a series of GP trainers who:

Ensure that all home visits are done by their GP registrars.

Ensure that all the on call work is done by the registrar.

Ensure that when they go to meetings the registrar covers their workload.

Ensure that if there is a visit each for a registrar and their trainer the registrar gets both.

Ensure that a registrar will cover their surgeries and on call whenever they can’t be arsed.

Ensure that the registrar on call for an out of hours session has all workload vetted by a trainer and done by the registrar

Such abuses are overseen, and approved by the RCGP. This was the experiences of the GPs and registrars we spoke to this week and is no different from those that we have endured under the 20+ years of VTS.

And some of the current RCGP abusers want GP training to go to 5 years? An extra 2 years of uninterrupted time on the golf course for GP trainers? Excellent.

There are a lot of intelligent GP trainees who despite having passed their exams are being abused by those meant to be supervising them.

There are also a lot of good and excellent GP Trainers who protect their Registrars from such abuse. This post is not about them it is about their less than professional colleagues.

This is not on.

Praise be to the Party for ensuring that despite slavery being illegal in the UK it still is allowed under the auspices of the RCGP. And this has been so for the last 20+ years and from what our younger colleagues were telling us was not too dissimilar to that which we experienced during our “training”.

Who can tell the RCGP of the abuse? None other than the GP Registrar who in order to qualify has to be signed up by none other than their abuser.

Sound familiar?


Anonymouse said...

"despite slavery being illegal in the UK it still is allowed under the auspices of the RCGP. "

During the Health Select Committee's investigation of MMC following the MTAS disaster, Steve Field sat next to Carol Black as they were being interviewed by the MPs. Despite the gastly unprecedented event, all he talked about for the whole time was how general practice was, is and must be considered 'a specialty' and how training should be extended to five years, because general practice was, is and must be considered 'a specialty', valued and cherished! The 'prof' never gave any of his valuable 'specialty' time to address the purpose of which he was summoned to attend that meeting, namely to discuss the 'blight'w of the MTAS victims who were on the brink of total ruin - that he never did, because it wasn't his concern! Carol Black looked so disgusted she nearly vomitted! BTW, she was appologetic for her role in the mess and I respect her for that. As for the forever self serving 'prof', he has an advanced inferiority complex. Time to see a psychiatrist 'colleague' perhaps?

And you Northern doc is, was and will always be a GP Dr who is, was, and will always be valued for, not only the great work s/he does but for his/her ethics too.

And you haven't spoken about the Ferrari for a while, I hope she's still cruising proud to that manor house on those twisting leafy narrow lanes up north :)

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