Thanks for the invite Cliff but I am really not up to that kind of
job
In fact if I were back in the UK I would be flogging my guts out in a busy
DGH instead of being Director of an ED in a teaching hospital which has
38,000 attendances and the ambition (backed by both mangement and projected
manpower plans) to employ 5 then up to 11 specialists providing a Regional
Emergency Medicine service from one base hospital and two rural branches.
Andrew is quite right consultant expansion is not inconsistent with a
planned reduction in trainees and this is about to start in Australasia in
2001.
It depends where you set your projected number of consultants and the UK
should have about 3000.
Having just spent a month in the UK I think it is just too hard to envisage.

One mega wealthy cardiology consultant/hospital director acquaintance in the
UK proudly told me how he had just ticked off his sole ED consultant for
spending too much money public money locums. After all the UK does not spend
enough of its "GDP" on healthcare. ( ??.. to afford to have decent ED
departments).I repeat this fellow is decedantly wealthy...
Somethings just don't add up about the inequities in healthcare.
I suspect the revolution in the expansion of Emergency Medicine in the UK
will be patient/politician/media scandal driven and sadly not be driven by
from sitting consultants. 
As my mentor Chris Baggoley once told me  - beware of those in the comfort
zone they are the greatest barrier to real progress. We should all reflect
on this from time to time.
JohnC
PS There is no College/Royal College of Emergency Medicine in the UK   

-----Original Message-----
From: Cliff Reid [mailto:[log in to unmask]]
Sent: Monday, 31 January 2000 12:06
To: [log in to unmask]
Subject: (recurring) sermon



John, please come back to England and become President of the Royal College 
of Emergency Medicine!

How can we expand the specialty when specialist registrar numbers are to be 
cut by more than two thirds? The consultants will be at home/clinic/ganglion

theatre while the A&E senior house officers will get their feedback from the

rheumatology SpR manning the MAU that day. Fantastic. If that's the case, 
then judging by a conversation amongst the 12 trainees at our regional 
meeting the other day, you can expect planeloads of disillusioned 5th year 
SpRs arriving down under in the next few years.

Cliff Reid FFAEM
Specialist Registrar in (A&) Emergency Medicine


>From: John Chambers <[log in to unmask]>
>Reply-To: [log in to unmask]
>To: "'Netcom pmunro'" <[log in to unmask]>
>CC: "[log in to unmask]" <[log in to unmask]>
>Subject: RE: split working
>Date: Mon, 31 Jan 2000 09:10:50 +1300
>
>An MAU is a medical assessment unit
>One of those places where doctors from other specialties come and play at
>emergency medicine while the "A&E" senior staff are elsewhere/busy or at
>home. Busy following up sprained ankles in clinics, removing ganglions on
>their hard faught "lists", counselling the SHOs about all the diagnoses 
>they
>stuffed up last weekend or answering genuine compliants from disatisfied
>patients.
>Expand the specialty of Emergency Medicine and the MAU while become what it
>should be - part of a good well staffed Emergency Medicine Department with
>Emergency specialists present and in charge of a team of young and
>enthusiastic registraras from a range of backgrounds.
>The new specialty of "Acute medicine" is a myth and as acheivable as GPs
>staffing Emergency Departments
>End of (recurring)sermon.
>JohnC


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