Yes Phil, this is the reality of UK emergency medicine (if I dare elevate us
to that term), most of us are SHO dependent. In our department SHOs see
around 80% of new patients, I can't even give you the precise figure 'cause
our IT sucks. We have two middle grades in a 60K department, we're years
behind some of our colleagues in this country, and decades behind our
colleagues in the Antipodes and North America. Yet we still get over 50
applicants per SHO place!

But I also believe that there's no harm in SHOs simply working hard and
experiencing clinical medicine, as long as they're adequately supported. The
best way to learn this business is with patients, not in a classroom. Just
look at the other specialties; they're all itching to get into theatre etc
to boost their experience; most of them spend over 80% of their time
involved in clinical care. Meanwhile our "leaders" suggest that our (higher)
trainees should spend only one-third of their time seeing new patients. It's
no wonder British emergency medicine is slow to catch up with the rest of
the world; our system is set up to be SHO dependent and there's no clear
sign of things changing.

Adrian Fogarty

----- Original Message -----
From: "Dr P Munro" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Tuesday, August 20, 2002 9:45 PM
Subject: Re: SHO BAND 2A ROTA


> No offence taken, Craig. I agree that we need more SHOs to make a decent
> rota but ours is genuinely JDC ratified 2A. As I said, we need to have
> locums when there is a middle grader and SHO off at the same time or to
> cover most study leave.
>
> SHOs are just roster fodder - SHOs see about 50% of the new patients
coming
> to our department (~1400-2000 per 6 months each), there is no way around
> this for most departments. Our middle graders see about 40% of new
patients,
> consultants 5% and locums 5%. This does not take into account those
patients
> who are seen by the middle graders or consultants with the SHOs.
>
> If we didn't support, supervise and train our SHOs, I would agree with
your
> sentiments but they are there to work as well as to train. We are careful
to
> lead by example and not ask them to do things that we are not prepared to
do
> ourselves.
>
> Despite this being so awful we continue to have about 25 applicants for
each
> SHO and middle grade post advertised.
>
> Phil Munro
> A&E Glasgow