Water

Today the FM went shopping. Whilst doing so she noticed some sainsburies basic mineral water. Who on earth decides that they need to cut back on costs and replace Buxtons or Evian with Basics mineral water?

Sift and Services

Like many Medical schools, the one attended by the Fuddled Medic sends students all over the place to different hospitals of different trusts so that we can be trained to become doctors. In theory the teaching provided at hospital A should be the same as those provided by hospitals B, C and D. However this is simply not the case. One hospital provides three hours of teaching on ECGs, the rest provide one hour.

How is this fair?

The Fuddled Medic is aware that students are becoming more “militant” and are demanding better value for money, especially with impending tuition fee rises on the horizon. In the future medical faculties can probably expect a bay of students sitting outside demanding the same level of teaching that their peers receive.

A few weeks ago the FM posted about teaching being cancelled; don’t be surprised if in a year or so medical students turn around and demand that it be rearranged. Indeed colleague of mine would probably have been quite rude and argued that they were being paid to teach and therefore cancelled teaching due to bank holidays was simply not good enough.

Exams

So the FM passes through some hoops that were put in front of her. Yet she does not feel that pleased. You see her results were all below (bar one) that of the mean and median for the year.

The FM does not like feeling like a slightly below average. Especially as one of the specialities was something that the FM is considering specialising in.

At least the FM passed, that is the main thing

Tennis and Fuddled

The Fuddled Medic is a tennis fan who enjoys playing and watching (all of the grand slams, not just wimbledon) tennis. She has just watched another news report on why there aren't many top British players.

Here is my moneys worth on why we have a problem

The Fuddled Medic wants to go swimming, £2.50. The FM wants to go to the gym, £3.00.
Going to play tennis at my local tennis courts, £7.50 per hour - even when none of the eight courts are being used. Indoor courts are £13.00 per hour.

Brilliant

Hope the chap doesn't get into trouble with any managers though. . .

Southern Cross

Why is the department of health getting involved? Isn't it a matter for the private sector? Esepcially as the current government loves the private sector so much? The thing with the private sector is that if a business is going to go bust - you let it go bust. That is the nature of competition and capitalism.

Ahh, but this is different, the department of health has to get involved to stop dear old Aunt Muriel find herself on the street wehn Southern Cross goes bankrupt.

Fair enough, but the whole point of the private sector is carrot and stick (failure), it has to have both.

And what happens in the future if private companies running bits and pieces of the NHS goes bankrupt? Do fancy new buildings used for patient care get sold off to pay debts? Do endoscopy lists that take place in a private hospital for NHS patients still get done?

etc etc

Ridiculous

The FM is referring to this article. Am pretty sure midwives know that alcohol is not the best of ideas during pregnancy, its as if people don't realise they are highly trained professionals.

Poor Kids

A Kid in Manchester will have a life expectancy of seven years less than that of a child in Barnet. Before the FM started medicine she did not give health inequality or the gap between rich and poor much though – she has given more thought to it since.

So why does it matter if a child grows up below the poverty line? Because there are higher chances of infections, anaemia, middle ear infection amongst many, many more.

Currently the FM is watching the BBC documentary, Poor Kids. Watching it is heartbreaking, currently at the bit where the girl in the flat in Glasgow where she shows us the damp. When clerking children in hospital it is important to do a proper social history, including to ask about any problems with damp at home.

The fact that 85% of children who live in damp suffer from breathing problems has popped onto my screen.

Let us assume the FM becomes a paediatrician. Will she do any good? Is there anything the FM could do about what she is watching? Or should she have gone into politics and tried to decrease the gap between rich and poor?

Bastards and Gunners

The Fuddled Medic is going to join a profession that include a whole lot of bastards. In one of the first lectures the FM attended the lecturer stated doctors have a higher than average amount of
· Racists
· Sexist
· Homophobes

As a profession we have a higher amount of bullies to. And this is something that is not just experienced by medical students but by junior doctors as well. Most students work on confidence, after a few weeks of things going well students start to believe that they might have what it takes to be a doctor. All it takes is for one bit of humiliation in front of eight other medical students for this to go, with poor student going backwards.

Buts what’s worse that this?

Gunners, the term given to overly (usually downright rude) competitive medical students. These are far worse in the FM’s mind. An arrogant consultant can be easily ignored, or thought off as old fashioned and ignorant. A Gunner will find it easier to sow doubts in minds. Are you doing enough work? Why can they answer questions that you can’t?

Unfortunately MTAS has made it much worse. In the good old days it was a case of pass or fail. Now it pays to be in the top 25 or 50% of year. This is wrong, either you are competent or you are not.

Privilege

One thing that annoys the Fuddled medic is people who don’t appreciate how lucky they are. At some stage (or quite regularly) medical students will get bored sitting in clinics staring at the back of the ophthalmologists head or standing in theatre. All medical students should be acutely aware that if they don’t really want to be there, many hundreds of other students would jump to have that opportunity.

Perhaps this is why the Fuddled Medic gets annoyed when she see’s other students skipping stuff. The time you skip a nursing shift or a clinic is a time that could be given to someone else. On a personal note there are clinics that were inspiring but the FM could only go to one due to other students being roistered in. The FM could have gone twice if she had known other students weren’t going to turn up.

So why the title of this blog post? One problem is that a significant proportion of people who got medical school come from a background where they have everything handed to them on a plate. How can you appreciate medical school when you have had to do relatively little work to get in? If you’ve been told what’s going to appear in exams, you’ve been coached in ethics, you’ve had lectures put on for you by the school, you’ve been coached on how to answer interview questions?

Does this post make me bitter? Or is it a valid observation? Certainly I don’t want a class war. And the Fuddled Medic has many good friends who went to private school, the difference being they appreciate how lucky they are.

Culture

The FM has been reading about the Panorama program about abuse at Winterbourne House. After reading about it and watching some of the clips she doesn’t think she could watch the program - it would be too much. But unfortunately the FM is not surprised. This type of thing is common and the FM believes part of it is due to the private sector being involved in the providing of care to vulnerable adults.

The FM has briefly blogged on this before. A significant part of it is due to staff being on minimum wage and a high staff turnover. And my next statement may seem judgemental, but if you pay minimum wage and as a society give the impression that care work is not worthwhile then you will attract the “wrong” type of people for the job.

Private care homes are very good at telling the regulatory bodies what they want to hear. The only way to reduce the amount of abuse is to have inspections that are completely unannounced and at random times.

But that won’t be enough, let’s face it the vast majority of people don’t give a dam about people with profound learning disability or mental health problems. We simply don’t consider them a worthy part of the population. We are more than happy for an important job such as being a care or support worker to be done by people who have relatively few qualifications and a poor educational background to do this job for pittance.

Coupled with the fact we are happy for private companies to provide the relevant training. And what will they do? Do it as cheaply as possible