JISCMail - ACAD-AE-MED Archives

Nam, a very good point about improved services leading to raised expectations; I agree entirely.

As regards postgraduate medical education, however, although not as intensive as some of the training schemes you mention, it has improved immeasurably over the last 10 years. Formal SpR training for one, is now streets ahead of what it used to be, and SpR supervision is also vastly improved, recognising that medics still learn best by workplace-based apprenticeship - as long as it's well supervised by consultants.

MMC does indeed provide strict criteria for its formal curriculum delivery in the Foundation Programme, over and above the formalised assessments you mention. The missing bit "in between", i.e. the ST years that will follow on from the Foundation Programme either as a bridge to higher specialist training, or as a straight "run through" into higher specialist training, will have a clear curriculum and robust assessment criteria built in over the next few years, in time for their August 2007 roll out. Much of this detail will become clear over the next six to twelve months.

Adrian Fogarty

Royal Free Hospital

London

nam <[log in to unmask]> wrote:

Perhaps I'm being a bit simplistic, but for the majority of conditions that the ECPs will be trained to deal with, why should those patients even be calling an ambulance in the first place? How many of us have been frustrated by patients attending by ambulance with a cut finger and theres' a subtle underlying belief that coming by ambulance bumps them up the queue? Bringing care to the home sounds a political winner; in reality how much more resource will be required for ECPs to attend within a certain target time as set from central government. Then if you make the service good, as has already been intimated, demand rises. People are already choosing A&E rather than GP as they know they will get seen within 4 hours. If they then can call an ambulance and get seen within, say, 2 hours at home, it doesn't take Einstein to figure out which option they'll choose.

Picking up a different thread from Martyn's e-mail:

>We still have systems where medicla staff acquire new skills without

>proper supervision and support, where the other HCPs acquiring the very

>same skills do so through structured programmes with formal assesmsents

>and occaisionally extremely prolonged periods of supervised and /or

>supported practice

This is probably very true but begs the question why are we letting down the future medical profession. If we trained our docs as intensively and extensively as we train ECP/ENP/surgical practitioners, etc. we would have a pretty awesome medical workforce. And yet, senior enthusiasm for training seems very hit and miss from Trust to Trust and Region to Region. We just don't seem to have the time for it amongst other commitments. So who is training up all these practitioners? I get the impression that these trainers get dedicated time and decent pay for what they do. Maybe we should be pushing this aspect for medical postgrad training? MMC has formalised assessment but isn't quite as didactic about how delivery of training will be improved within a shorter timeframe.

Nam Tong,

King's Lynn