Good points. I know a very senior member of the specialty who told someone
with MRCSEd(A&E) who was enquiring about an SpR post that he/she didn't rate
the exam as much as FRCS or MRCP. The reason given was that to get the A&E
exam, it's never necessary to work as more than a junior SHO in any
specialty, whereas the acquisition of one of the other exams implies that
registrar level has been reached in a specialty and therefore the doctor has
experienced working at more senior level of competence and responsibility.
While this negative response only served to discourage the poor girl, the
points raised give food for thought.
I do however feel we should support our own specialty's exam. While I'm sure
some of the knowledge and many of the practical skills acquired for FRCS are
useful in A&E, I don't see a lot of the Charcot-Marie-Tooth disease or
dystrophia myotonica that was so important for MRCP. I DO see a lot of acute
medicine though, so it seems to me the experience from the jobs is markedly
more useful than the exam you get at the end of them. Maybe when we get SpR
secondments right that will go some way towards avoiding the 'narrowly
focussed set of skills' you and I are wary of.
I'd be interested to hear of anyone's experience of US emergency physicians.
I understand they only have 4 year residencies in EM, which they can enter
straight after med school, and we don't hear of their skills being narrowly
focussed. I'm sure it boils down to differences in interpretation of the
word 'training'. In the UK an SpR is so often left to his own devices for
most of his training he HAS to rely on the skills and knowledge acquired
during his SHO posts. As the Faculty works to improve the structure and
content of SpR training, we should all finish up with excellent broad-based
abilities regardless of what post-nominal letters we traded a happy life in
our 20's to acquire. Until we get there, I agree with you that the
broader-based our experience, the more we can offer our patients.
Cliff
Paed registrar without MRCPCH, and suffering!
Australia
>From: Stephen Hughes <[log in to unmask]>
>We should all be moving towards senior-based care.
>That requires entrants to the specialty with a lot of experience.
>
>Such experience should be broad-based.
>
>That takes time.
>
>In short, there are no short-cuts if you want to practice A/E medicine,
>which as we all know stands for "Anything and Everything".
>
>While we're at it, is the FRCS(A/E) such a good idea anyway? One of the
>things that I like about A/E is the broad background of many of us. On
>my own rotation, there are physicians, surgeons and a radiologist as
>well as holders of the A/E exam. (The anaesthetist wandered off back to
>anaesthetics a couple of years ago).
>
>Of the last group, they are far from the homogenous "one size fits all"
>group nightmare, but I think that in the future, an abbreviated training
>with a narrowly focussed set of skills will not do the specialty any
>favours.
>--
>Stephen Hughes FRCSEd (Not A/E)
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