>From: Adrian Fogarty <[log in to unmask]>
>
>Realistically however we can slowly work towards 8 consultant >departments,
>and personally I don't relish the
>thought of signing off every patient like the Americans do, though no
> >doubt it'll happen someday! I expect BAEM are doing work on these
> >numbers as we speak?
The College of Anaesthetists here ( and I assume its similar in the UK)
require that all their trainees spend at least six months under full
supervision, before they are allowed to work alone. For the next year or so,
they receive high levels in specialist input, and discuss most cases with
their consultant and are supervised for all but the most minor cases.
An ED SHO arrives, is given a short induction and left to "go for it", with
varying levels of senior input and support from unit to unit - some
excellent, some shocking. I think there is a strong case to be made for much
greater levels of senior supervision - and I believe that all new SHO's
should have to discuss EVERY patient with a middle grade or senior, ( how
long for ???? ) and that SpR's in their first year, should be discussing all
of their critically ill or complicated patients with a Specialist. I learn
alot from discussing my seriously ill patients with a consultant - and I
wonder what the UK trainee's are missing out on by not having an expanded
senior cover. Anecdotally Im sure everyone is aware of the huge amount of
sub-obtimal ( not always wrong or leading to an adverse outcome - just
sub-optimal ) management that goes on due to lack of experience or over
confidence from junior staff. Im not convienced a period of absolute
supervision at both junior and middle grade isnt required. Its obviously
partially a resources question. The American model may be overkill - but its
closer to the ideal than the current UK situation - isnt it ?
Any thoughts ?
Craig
New Zealand
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