Utterly amazed at the lack of vision and ambition in the projected number of
(Accident &)Emergency Medicine posts that the UK will need by the middle of
the next decade.
Should probably be multiplied by 6 ie 3600. This would compare reasonably to
the projections of the Australasian College (1200 posts in by 2005) although
probably still a bit on the low side.
The public will demand a specialist presence in the department sooner than
you think and the politicians ( and Trusts) will have to respond.
Beware of a profession matching its plans to suit itself (and perhaps
reflecting the working patterns of the present office holders) and not the
needs of the patients.
There will be no bottleneck, rather a gaping hole which "rejects" from other
specialties will seek to fill. The "acute general internal physicians" are
waiting in the wings.
I wish our profession had more self respect and self confidence. It all
starts by respecting the patients and not blaming them for being there in
the first place ( such as is demonstrated by comments and studies implying
that patients attend "inappropriately").
End of the sermon (It is Sunday here down under)
Best wishes
JohnC
-----Original Message-----
From: Cliff Reid [mailto:[log in to unmask]]
Sent: Sunday, 26 September 1999 02:05
To: [log in to unmask]
Subject: Willies
I understand that with current numbers of A&E trainees and expected
retirements, BAEM's recommendation of around 800 consultants will become a
reality around the middle of the next decade. In order to prevent the
bottleneck disaster that befell O&G specialists, consideration has to be
given to a dramatic reduction in A&E training posts, which may result in
perhaps just teaching hospitals having SpRs in A&E.
This gives me the willies. Without SpRs, who will provide middle grade cover
in most DGHs? As far as my limited imagination sees it the options are:
Hire non consultant career grades - but where will they come from? The good
ones in my region are like gold dust.
'Import' foreign doctors
Get the Consultants to do the 'middle grade' cover - is that realistic in a
3 or 4 consultant department?
Not have middle grade cover - just SHOs with consultants on call from home,
like the 'good old days'
Whichever way I look at this I can't help thinking either the specialty is
put back at least ten years or consultants are going to get shafted. Either
way the quality of emergency care for patients is not going to benefit. Is
it time we push for a consultant-based service so that adequate consultant
and trainee numbers are provided for, or do we stick with the consultant-led
principle, with its associated catch-22 situation? Am I overestimating the
contribution made by SpRs to quality A&E service delivery?
I would value the opinions of both my senior colleagues and fellow trainees
on this. At a time when the development and credibility of the specialty
seem to be gaining momentum, this news has shaken my optimism somewhat.
Cliff Reid
SpR in (Accident &) Emergency Medicine
North Hampshire Hospital
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