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The entire medical system of training in the UK needs reform. You spend six years (more or less) at university, racking up debt. Once you graduate, you spend t

The entire medical system of training in the UK needs reform. You spend six years (more or less) at university, racking up debt. Once you graduate, you spend two years as a "F1/F2", where you basically get bullied and do clerical work. Once you've completed these two years, you can apply for specialist training. You are working 60 hour weeks doing 1/4 night shifts (if you're lucky) and 1/3 weekend. Not only that you move hospital every six months. in london this is kinda feasible, else where it means a 2 hour commute. The starting wage for an F1 is £24-36k After the first two years you can apply for specialist training. However the attrition rate is horrific: https://www.bmj.com/content/364/bmj.l523.full https://www.bmj.com/content/364/bmj.l523.full loosing 64% of your trainees after 8 years of training is just pathetic. Some of this is government based, but a lot is the medical establishment being utter shits. bullying is rife, the "leaders" have a lot of "I managed it, it didn't do me any harm", there is no incentive to change because everyone rotates every 6months, so why bother putting effort in?

chrisseaton 5y ago
Yeah people talk about being a doctor like it's a great and prestigious job. No you get paid a basic salary to work 60 hours, and it's all on-site, unsocial hours, in grim buildings, with little choice about what you do.
- dankboys 5y ago
  That's fair. Unfortunately in the UK at least, the question of "how come student doctors can't afford rent when we give 25% of tax receipts to the NHS" it's too close to criticism of the NHS, a secular heresy.
mhh__ 5y ago
Basically everything in the UK needs reform as far as I'm concerned. We've had the same party in government for 12 years now and it shows.
- Beltalowda 5y ago
  That's pretty much the exact same thing people said at the end of the Blair/Brown Labour years. And their decade+ of power isn't a decade I'm looking at with great fondness either (politically speaking anyway). I think the bigger issue is just that the political system doesn't work very well, and hasn't for quite some time. Part of this is due to the system itself (e.g. first-past-the-post constituencies), and part of it is cultural (e.g. a nasty mean-spirited press insistently ridiculing politicians for a slightly awkward photo of eating a sandwich).
  - mhh__ 5y ago
    Poor people lives got better under Blair, whereas the Tories have gutted large amounts of the state. If it wasn't for Iraq people would (and do if you ask them specifics) look back on New Labour policy favourably. It's very easy to wax poetical about systemic change, and I often will too, but i don't want this government's absolutely awful record to be swept under a rug of abstraction.
    - aahortwwy 5y ago
      > If it wasn't for Iraq But it was.
- formerkrogemp 5y ago
  The slightest majority always blame labour when it's been the Tories in power for over a decade with all of the scandals. People can and will vote against their own interests out of spite.
willnonya 5y ago
Repeatedly leaning on bullying undermines any other points you try to make. In the end what you need isn't a government spending solution but rather a free market solution. That and a less whiny attitude...
- KaiserPro 5y ago
  I'm not sure if your joking or not. The first effect of a free market is that staffing costs will double almost instantly. A 10% vacancy rate and a 8-16 year lag for doctors and a 6 year lag for nurses will create inflationary pressures for staff. Without a proper regulation structure there will be a drop in care (free market means profit, which means cost cutting which means understaffing. Just look at holland) The second effect of free market will mean that only dense cities will have good facilities. Again, cities are the only place where you can run a profitable specialist centre. What you are failing to grasp from my post is that the 50% of the issue with the NHS are largely cultural. Changing culture is hard. Yes there are opportunities to create efficiency, but frankly there aren't enough staff to do that. This means spending more money on the NHS.
- WarChortle 5y ago
  > Repeatedly leaning on bullying undermines any other points you try to make. > That and a less whiny attitude That was quick! Also a free market solution does not work for inelastic demands. Its not the end all be all it works great for some things Health Care is not one of them.
lloydatkinson 5y ago
Like a lot of things in the UK this sounds like a totally incompetent training process
SilasX 5y ago
There was a great Reddit thread where a young lady (UK) told her dad she was training to be a nurse, and he assumed (like how things worked in his time, in his profession), she'd be working at a hospital soon. She had to explain that ... no, she has to do two years in a classroom, then internships, paying for it and all her expenses from non-nursing income, before she gets to that stage. The dad was dumbfounded at how that was even possible. https://old.reddit.com/r/AdviceAnimals/comments/2kbxs2/student_loan_bubble/clk2rj7/ https://old.reddit.com/r/AdviceAnimals/comments/2kbxs2/stude...
- djbebs 5y ago
  That's just the inevitable result of increasingly stringent regulations
- LigmaYC 5y ago
  To be fair, you have to be a high school graduate to think the current nurse career path is a great idea. Entry level jobs were better before universities monopolized them.

chrisseaton 5y ago

Yeah people talk about being a doctor like it's a great and prestigious job. No you get paid a basic salary to work 60 hours, and it's all on-site, unsocial hours, in grim buildings, with little choice about what you do.

dankboys 5y ago
That's fair. Unfortunately in the UK at least, the question of "how come student doctors can't afford rent when we give 25% of tax receipts to the NHS" it's too close to criticism of the NHS, a secular heresy.

mhh__ 5y ago

Basically everything in the UK needs reform as far as I'm concerned. We've had the same party in government for 12 years now and it shows.

Beltalowda 5y ago
That's pretty much the exact same thing people said at the end of the Blair/Brown Labour years. And their decade+ of power isn't a decade I'm looking at with great fondness either (politically speaking anyway). I think the bigger issue is just that the political system doesn't work very well, and hasn't for quite some time. Part of this is due to the system itself (e.g. first-past-the-post constituencies), and part of it is cultural (e.g. a nasty mean-spirited press insistently ridiculing politicians for a slightly awkward photo of eating a sandwich).
- mhh__ 5y ago
  Poor people lives got better under Blair, whereas the Tories have gutted large amounts of the state. If it wasn't for Iraq people would (and do if you ask them specifics) look back on New Labour policy favourably. It's very easy to wax poetical about systemic change, and I often will too, but i don't want this government's absolutely awful record to be swept under a rug of abstraction.
  - aahortwwy 5y ago
    > If it wasn't for Iraq But it was.
formerkrogemp 5y ago
The slightest majority always blame labour when it's been the Tories in power for over a decade with all of the scandals. People can and will vote against their own interests out of spite.

willnonya 5y ago

Repeatedly leaning on bullying undermines any other points you try to make. In the end what you need isn't a government spending solution but rather a free market solution. That and a less whiny attitude...

KaiserPro 5y ago
I'm not sure if your joking or not. The first effect of a free market is that staffing costs will double almost instantly. A 10% vacancy rate and a 8-16 year lag for doctors and a 6 year lag for nurses will create inflationary pressures for staff. Without a proper regulation structure there will be a drop in care (free market means profit, which means cost cutting which means understaffing. Just look at holland) The second effect of free market will mean that only dense cities will have good facilities. Again, cities are the only place where you can run a profitable specialist centre. What you are failing to grasp from my post is that the 50% of the issue with the NHS are largely cultural. Changing culture is hard. Yes there are opportunities to create efficiency, but frankly there aren't enough staff to do that. This means spending more money on the NHS.
WarChortle 5y ago
> Repeatedly leaning on bullying undermines any other points you try to make. > That and a less whiny attitude That was quick! Also a free market solution does not work for inelastic demands. Its not the end all be all it works great for some things Health Care is not one of them.

lloydatkinson 5y ago

Like a lot of things in the UK this sounds like a totally incompetent training process

SilasX 5y ago

There was a great Reddit thread where a young lady (UK) told her dad she was training to be a nurse, and he assumed (like how things worked in his time, in his profession), she'd be working at a hospital soon. She had to explain that ... no, she has to do two years in a classroom, then internships, paying for it and all her expenses from non-nursing income, before she gets to that stage. The dad was dumbfounded at how that was even possible. https://old.reddit.com/r/AdviceAnimals/comments/2kbxs2/student_loan_bubble/clk2rj7/ https://old.reddit.com/r/AdviceAnimals/comments/2kbxs2/stude...

djbebs 5y ago
That's just the inevitable result of increasingly stringent regulations
LigmaYC 5y ago
To be fair, you have to be a high school graduate to think the current nurse career path is a great idea. Entry level jobs were better before universities monopolized them.