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In message <002701c03c2a$5dfb09c0$f46001d5@z8v7o8>, Adrian Fogarty <[log in to unmask]> writes >I'm a huge cynic of the way ALS is taught although I agree >with most of the principles on which it is based. I'm also dispirited by the >way many people view the ALS certificate as some sort of qualification; >several recent advertisements for A&E consultant posts listed ALS >certification as a prerequisite for the job!! I think this is elevating a >two day course with a 95% pass rate to a ridiculous level. I could go on but >it depresses me too much... Allow me to become depressed on your behalf. I've only been involved with ALS courses for a short time but have formed the impression that "candidates" are taught to "pass" the "exam" rather than learn anything useful from the experience. Some staff I work with have been totally unable to answer the most basic resus-related question a week after succesfully completing the course. Others have been very interested and expanded on their knowledge and skills from the course, but they are in the minority. It seems a little strange that the core material from a course with a very high pass rate can be so completely forgotten a week later. Did I hear someone mention MB.BS? Got a sneaking suspicion that the standard required by an individual candidate is determined by that candidate's background and experience, rather than their knowledge or performance. From a candidates viewpoint, the ATLS seemed much more "practical" and less intimidating. Can't help feeling that all-doctor faculty and all-doctor candidates helped. Are the right people teaching the right stuff to the right candidates? Is it time to sacrifice the ideal of one ALS course for all in favour of more tailored courses for specific staff groups (shock-horror herecy)? As for the requirement for an A&E Con to have ALS certification - why not, and APLS and ATLS too? Or are they too good for that? Perhaps I'm too good as well. Perhaps so too are the med/surg/paed reg that responds to cardiacs/traumas/paed arrests. I continue to be astonished that these staff may NOT necessarily be required to have the relevant course under their belt as a MINIMUM requirement to take the emergency bleep. Like it or not, in these days of governance and re-validation, some surrogate of relevant basic clinical skills is essential for ALL grades, rather than just taking our word for it that we are s**t-hot and have been doing this job for X years. These courses are not an ideal marker and certainly should not be the only measure, but I would be concerned if I had to work with a senior collegue who hadn't "bothered" with his/her ALS/ATLS/PALS etc. Why not?. Am I the only one who can still remember A&E Consultants who would freely admit that they weren't comfortable with "all that resus stuff" but still carried the title (and salary) of an A&E Consultant? There aren't any out there now, of course. You mentioned a paed Anaesthetic Consultant "failing" an airway station - why? The skills tested are basic and I would be concerned as to the reason for not being able to perform them adequately. It's quite dangerous to assume the course was at fault. I've worked with a Consultant Anaesthetist with responsibility for trauma patients on ITU in a major teaching hospital within the last few years who might have done some serious damage with a chest drain one day had a colleague not wandered by at the opportune moment (patient had developed tension pneumo on IPPV after blunt trauma). That Consultant hadn't been on an ATLS course - but then he didn't need to of course, because he'd taken 10 years to train to be a Consultant and had full FRCA. Anyway, if he had gone on some meaningless ATLS course, he'd probably have been failed on his knowledge of chest drain insertion technique by some junior upstart ;-) Every week an incompetent colleague is pictured outside the GMC. All of them have been KNOWN to be "quite safe" by several docs they've worked with. Soon, we will all be required to regularly produce evidence of maintained basic skills and knowledge. If the current courses / assessment aren't relevant then scrap them and invent new ones. Dr G Ray Staff Grade A&E Sussex Reply to [log in to unmask] %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%