Monday, 30 April 2012

Yessum mistress beat us some more.

A while back we did a piece on how members of the Royal College of General Practitioners (RCGP) exploit GP registrars in a similar way to which certain ecclesiastical organizations treated those juniors in their care for their spiritual betterment. If you have not been on the receiving end of senior members of the RCGP exploitation of GP trainees (now called GP registrars) you will not understand where this piece is coming from. We would suggest you read our previous piece before reading further.

A former main stay of our early blog reading has pointed out in one of their much missed posts (hint) what another newer blogger has written which has sparked a huge number of comments including those from the new Uncle Tom of the RCGP sorry we meant nice Auntie Clare about the proposed extension of GP “training”.

The doctors in training we have had here at ND Central, our GP registrars, our F2 doctors and our medical students have all been groomed as per the current generation of ivory towered educationalists and all have said the same thing at some point during their time with us.

"We learn most from seeing and treating patients on our own".

This is akin to flying. You need a certain amount of training to be able to fly but you learn most from your personal experience. Now we would not suggest a mere 7 hours in a Spit as being adequate to enable a new GP to take to the flying of their patients in practice but for years the current system has worked.

Our doctors in training also comment about how retarded the eportfolio and the buzzword “reflection” is and resent having to complete it to keep their RCGP overseers happy. The same overseers never had to do this complete waste of time so does that mean their trainers are in fact crap doctors ill prepared to be full time GPs in the 21st century as they never did any electronic “reflection”?

Most of our doctors in training are bright and will very quickly analyse a situation and realize if there is a problem and because they are conscientious strive to correct any error and learn and remember how better to perform next time. The human brain is a complex computer and this type of education is adaptive unlike an epratfolio where hours of retarded reflection will be of little use if you suddenly can’t get your gear down or an engine fails. Another year of debriefs and eportfolio box ticking will be of no extra benefit compared to a year of flying solo.

The poorly performing doctor will not be weeded out by the epratfolio for we have dealt with these and they are bright enough to realize how to have a shining eportfolio while being completely useless. This is akin to a pilot with a logbook showing many hours in the air who can barely fly.

The more hours in the air you have the better a pilot you should become (assuming that basic training has been correct). There are minimum numbers of hours needed to fly different types of aircraft and we are sure that Auntie Claire would be happy to board an aircraft the pilot of which had done more hours reflecting on their simulation flying than flying the real thing especially if Auntie Claire’s ticket was that much cheaper as a result of similar reforms of the aviation industry.

No doubt Auntie Claire feels that the extra year of hours on the epratfolio will mean a nGP registrar will be able to think more for themselves having been groomed and exploited for another year of debriefs and already the medical press are suggesting that this year will be spent in areas that most GP trainers would not touch with a barge pole.

Those of us who have been collectively abused over many years by former senior abusers, sorry members, nay fellows of the RCGP have not reflected on this abuse as being good we have analyzed it and learnt that it was bad and as such have changed our practice to ensure that we protect our doctors in training from this kind of exploitation and abuse.

Our personal experience is that GP trainees/registrars were used, sorry trained, to allow the trainer more work avoidance or opportunities to do other (more lucrative or interesting) things than treat their own patients. Give GP registrars an extra year of flight simulation and “reflection” thereof and that will not make them better GPs in the same way that less hours flying make for better and safer pilots.

But just like in Uncle Tom slaves are there to be exploited by their masters and mistresses. And like those who have been abused abusees accept this as the norm and perpetuate further abuse to maintain the status quo unless they rebel or resist.

Tell us Auntie Claire who should we believe and why is it a good idea for an extra year? Obviously you support the idea of clinical commissioning as does a once a weak man who thought 5 years would be better. In order for experienced GPs to be able to do clinical commissioning or RCGP work they will need someone to cover their surgeries.

Is your extra year merely a way of ensuring a cheap supply of experienced labour to enable their overseers more time away from practice without having to pay for expensive fully trained GP locums?

Or will they be claiming locum expenses and using GP registrars instead? Don’t laugh we know this has happened and happens.

Will free thinking GPs involved in training lie down and let someone tickle their belly and say yessum this sure feels good or will they stand up for their GP registrars? Will GP trainers opt to wear blue to protect GPs in training from exploitation or don the grey, whistle Dixie and tell their GPs in training to go pick some more cotton, dawg?

Praise be to the Party for continuing to provide high quality medical services by driving down costs and exploitation of those in training. Is there any Abraham Lincoln anywhere amongst the current crop of overseers in the medical educational establishment at present?

We’d better get back to picking some more cotton in case we get Scot juniored by another group of overseers.

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