> I think all A&E should have middle grade cover 24 hours and I
> was surprised
> to hear there is a shortage in parts of England as all the
> jobs up here are
> usually easily filled.
> Maybe your rotas have to be made more attractive to lure more of the
> trainees to come down south?
>
In general there's no trouble filling SpR and SHO posts. The difficulty lies
in filling staff grade posts with good people- in a sustainable system you
have to have around 5 times as many consultants as SpRs because you spend
about 5 times as long as a consultant. OK, at the moment there's a big
expansion going on, so SpR numbers are fairly high, but the SpR: consultant
ratio is still about 2:1, I think (I presume someone has the figures to hand
and can correct me). Means for the typical department to have 7 middle
grades, either you've got 14 consultants or you need some staff grades. The
problem with staff grades isn't a general one that the on calls are tough,
it's more that they vary- a staff grade is less likely to take on a job that
means they'll be up all night on call if they've the option of being paid
the same to sleep while resident in another department or a post that
doesn't involve nights at all.
Matt Dunn
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