Perhaps I am just getting old, but the latest crop of SHOs, although the
nicest and most charming of people, are really rather dubious in the
skills and decision-making department. Review Clinic was full of sprained
ankles that did not require review and some ST segment elevation was sent
home.
Should we now be having a debate about the most junior person safe to be
an A&E SHO? Traditionally it is the first job after House jobs, and most
of mine are. But as the house job is now a glorified final student year
are we not unfairly exposing people who are not yet equipped to make safe
decisions with a huge burden? Should we be saying we want to see a job or
two as an SHO in hospital with a system to let them out slowly?
Or should we be going back to the medical schools and asking some
pertinent questions about student training? Or am I the only one with this
thought this time? I doubt it, as I hear stories of medical registrars who
can't put central lines in and surgical registrars who have not done
anything more taxing than close other people's incisions. In the current
climate of quality pursuits can we justify dropping these SHOs in it? And
if not, how do we ensure someone improves their training?
Best wishes,
Rowley Cottingham
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No, my powers can only be used for good.
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