Am not sure that all SpRs have enough minors experience Matt, especially if
they come from a medical background, as they do increasingly these days.
Besides, as you suggest, practising even simple minors can be useful. But I
take your point, SpRs shouldn't be routinely used for queue-busting
straightforward stuff. At the moment they are expected to do this for a
certain percentage of the time, but a proportion of their salary is "service
based" to reflect this (this may not continue forever). However I don't
believe this type of work is excessive in my own department but one does
hear horror stories!
Adrian Fogarty
----- Original Message -----
From: "Dunn Matthew Dr.
Subject: Re: A vision - or am I just being paranoid?
> That's great- if a SpR spends the great majority of their time seeing or
> advising on critically ill patients or difficult 'minor' problems (which I
> agree can be complex and important) they are gaining useful experience.
> However, my experience across departments has led me to believe that the
> majority of workload (particularly in inner city departments) consists of
> simple 'minors'. If a SpR spends too much of their time dealing with these
> they lose the oportunity for valuable experience elsewhere.
>
> Again, a SpR with a high service commitment may be too busy to
> access learning resources.
>
> In a procedure based speciality, yes. Continuing to do even relatively
> simple procedures is useful (akin to a musician practising scales and
> arpeggios). Service committment that consists of procedures particularly
> more complicated procedures is always useful. However in a more diagnosis
> based speciality, exposure to a wider range of conditions is important.
> Minor injuries are important, but it is likely that by the time of
starting
> HST, a SpR has already seen sufficient of most of them. Where SpRs tend to
> be deficient is in management of the critically ill patient. Even in
> surgery, the more senior trainees are keen to learn and practice certain
> operations, but for a surgical SpR in the later stages to spend most of
> their time doing routine follow up clinics or simpler operations would not
> be considered acceptable- you learn by doing an operation for the first
few
> times, but the learning curve does plateau.
>
> While practical experience is important, it is my belief that SpR training
> could be improved by increasing the emphasis on training at the expense of
> service commitment- even when I was a registrar there were cases where I
was
> drawn away from seriously ill patients (or had to refer them on to
inpatient
> specialities) in order to clear waiting times. The vibes I'm getting is
that
> this problem is worsening. This compromises training, and in my view is
> analagous not to surgical SpRs spending time in theatre, but to surgical
> SpRs being drawn out of theatre to clerk in routine admissions.
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